Diagnosis and Treatment of Insomnia Comorbid with Obstructive Sleep Apnea

Leon Lack; Alexander Sweetman

doi:10.1016/j.jsmc.2016.05.006

Diagnosis and Treatment of Insomnia Comorbid with Obstructive Sleep Apnea

Sleep Med Clin. 2016 Sep;11(3):379-88. doi: 10.1016/j.jsmc.2016.05.006. Epub 2016 Jul 21.

Authors

Leon Lack¹, Alexander Sweetman²

Affiliations

¹ School of Psychology, Flinders University of South Australia, Adelaide, South Australia, Australia. Electronic address: Leon.lack@flinders.edu.au.
² School of Psychology, Flinders University of South Australia, Adelaide, South Australia, Australia.

PMID: 27542883
DOI: 10.1016/j.jsmc.2016.05.006

Abstract

Insomnia is often comorbid with obstructive sleep apnea. It reduces positive airway pressure (PAP) therapy acceptance and adherence. Comorbid patients show greater daytime impairments and poorer health outcomes. The insomnia often goes undiagnosed, undertreated, or untreated. Pharmacotherapy is not recommended for long-term treatment. Although care should be taken administering behavioral therapies to patients with elevated sleepiness, cognitive behavior therapy for insomnia (CBTi) is an effective and durable nondrug therapy that reduces symptoms and may increase the effectiveness of PAP therapy. Sleep clinics should be alert to comorbid insomnia and provide adequate diagnostic tools and clinicians with CBTi expertise.

Keywords: CBTi; Comorbid insomnia; Nondrug insomnia treatment; OSA; PAP adherence; PAP therapy.

Publication types

Review

MeSH terms

Comorbidity*
Humans
Sleep Apnea, Obstructive / epidemiology*
Sleep Initiation and Maintenance Disorders* / diagnosis
Sleep Initiation and Maintenance Disorders* / epidemiology
Sleep Initiation and Maintenance Disorders* / therapy