Sleep structure in patients with COMISA compared to OSA and insomnia

Bernice M. Wulterkens; Lieke W.A. Hermans; Pedro Fonseca; Jerryll Asin; Nanny Duis; Hennie C.J.P. Janssen; Sebastiaan Overeem; Merel M. van Gilst

doi:10.5664/jcsm.10500

Sleep structure in patients with COMISA compared to OSA and insomnia

Bernice M. Wulterkens (Corresponding author), Lieke W.A. Hermans, Pedro Fonseca, Jerryll Asin, Nanny Duis, Hennie C.J.P. Janssen, Sebastiaan Overeem, Merel M. van Gilst

Onderzoeksoutput: Bijdrage aan tijdschrift › Tijdschriftartikel › Academic › peer review

7 Citaten (Scopus)

133 Downloads (Pure)

Samenvatting

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) and insomnia frequently co-occur, making diagnosis and treatment challenging. We investigated differences in sleep structure between patients with OSA, insomnia, and comorbid insomnia and sleep apnea (COMISA) to identify characteristics that can be used to improve the diagnosis of COMISA.

METHODS: We obtained polysomnography data of 326 patients from the Sleep and OSA Monitoring with Non-Invasive Applications database. The group included patients with OSA (n = 199), insomnia (n = 47), and COMISA (n = 80). We compared statistics related to sleep structure between the 3 patient groups.

RESULTS: Wake after sleep onset was significantly shorter for the OSA group (median: 60.0 minutes) compared to the COMISA (median: 83.3 minutes, P < .01) and the insomnia (median: 83.5 minutes, P = .01) groups. No significant differences were found in the total number of awakenings and the number of short (up to and including 2 minutes) and medium-length awakenings (2.5 up to and including 4.5 minutes). However, the number of long awakenings (5 minutes or longer) and wake after sleep onset containing only long awakenings was significantly lower for patients with OSA (median: 2 awakenings and 25.5 minutes) compared to patients with COMISA (median: 3 awakenings, P < .01 and 43.3 minutes, P < .001) or with insomnia (median: 3 awakenings, P < .01 and 56.0 minutes, P < .001). Total sleep time was significantly longer and sleep efficiency was significantly higher for the OSA group (median: 418.5 minutes and 84.4%) compared to both the COMISA (median: 391.5 minutes, P < .001 and 77.3%, P < .001) and the insomnia (median: 381.5 minutes, P < .001 and 78.2%, P < .001) groups. The number of sleep-stage transitions during the night for patients with COMISA (median: 194.0) was lower compared to that for patients with OSA (median: 218.0, P < .01) and higher compared to that for patients with insomnia (median: 156.0, P < .001). Other sleep architectural parameters were not discriminative between the groups.

CONCLUSIONS: Patients with COMISA show specific characteristics of insomnia, including prolonged awakenings. This variable is distinctive in comparison to patients with OSA. The combination of prolonged awakenings and the presence of sleep-disordered breathing leads to increased sleep disturbance compared to patients having only 1 of the sleep disorders.

Originele taal-2	Engels
Pagina's (van-tot)	1051-1059
Aantal pagina's	9
Tijdschrift	Journal of Clinical Sleep Medicine
Volume	19
Nummer van het tijdschrift	6
DOI's	https://doi.org/10.5664/jcsm.10500
Status	Gepubliceerd - 1 jun. 2023

Financiering

All authors have seen and approved the manuscript. This work was performed within the IMPULS framework of the Eindhoven MedTech Innovation Center (e/MTIC, incorporating Eindhoven University of Technology, Philips Research, and Sleep Medicine Center Kempenhaeghe), including a PPS supplement from the Dutch Ministry of Economic Affairs and Climate Policy. Additional funding was provided by STW/IWT in the context of the OSA+ project (no. 14619). At the time of writing, P.F. and L.W.A.H. were employed and/or affiliated with Royal Philips, a commercial company and manufacturer of consumer and medical electronic devices, commercializing products in the area of sleep diagnostics and sleep therapy. Philips had no role in the study design, decision to publish, or preparation of the manuscript. J.A. received financial support from Philips and SomnoMed for research and participated in advisory boards for Jazz Pharmaceuticals and Bioprojet, all unrelated to the present work. S.O. received an unrestricted research grant from UCB Pharma and participated in advisory boards for UCB Pharma, Jazz Pharmaceuticals, Takeda, and Bioprojet, all paid to the institution and all unrelated to the present work. The other authors report no conflicts of interest.

Financiers	Financiernummer
STW

Toegang tot document

10.5664/jcsm.10500

pdfDefinitieve gepubliceerde versie, 540 KBLicentie: TAVERNE

Andere bestanden en links

Link naar publicatie in Scopus

Sleep Medicine
van Gilst, M. M. (Content manager) & van der Hout-van der Jagt, M. B. (Content manager)
Impact: Research Topic/Theme (at group level)

Citeer dit

@article{3566e6364f364b95bbce6ca7ae7ef566,

title = "Sleep structure in patients with COMISA compared to OSA and insomnia",

abstract = "STUDY OBJECTIVES: Obstructive sleep apnea (OSA) and insomnia frequently co-occur, making diagnosis and treatment challenging. We investigated differences in sleep structure between patients with OSA, insomnia, and comorbid insomnia and sleep apnea (COMISA) to identify characteristics that can be used to improve the diagnosis of COMISA.METHODS: We obtained polysomnography data of 326 patients from the Sleep and OSA Monitoring with Non-Invasive Applications database. The group included patients with OSA (n = 199), insomnia (n = 47), and COMISA (n = 80). We compared statistics related to sleep structure between the 3 patient groups.RESULTS: Wake after sleep onset was significantly shorter for the OSA group (median: 60.0 minutes) compared to the COMISA (median: 83.3 minutes, P < .01) and the insomnia (median: 83.5 minutes, P = .01) groups. No significant differences were found in the total number of awakenings and the number of short (up to and including 2 minutes) and medium-length awakenings (2.5 up to and including 4.5 minutes). However, the number of long awakenings (5 minutes or longer) and wake after sleep onset containing only long awakenings was significantly lower for patients with OSA (median: 2 awakenings and 25.5 minutes) compared to patients with COMISA (median: 3 awakenings, P < .01 and 43.3 minutes, P < .001) or with insomnia (median: 3 awakenings, P < .01 and 56.0 minutes, P < .001). Total sleep time was significantly longer and sleep efficiency was significantly higher for the OSA group (median: 418.5 minutes and 84.4%) compared to both the COMISA (median: 391.5 minutes, P < .001 and 77.3%, P < .001) and the insomnia (median: 381.5 minutes, P < .001 and 78.2%, P < .001) groups. The number of sleep-stage transitions during the night for patients with COMISA (median: 194.0) was lower compared to that for patients with OSA (median: 218.0, P < .01) and higher compared to that for patients with insomnia (median: 156.0, P < .001). Other sleep architectural parameters were not discriminative between the groups. CONCLUSIONS: Patients with COMISA show specific characteristics of insomnia, including prolonged awakenings. This variable is distinctive in comparison to patients with OSA. The combination of prolonged awakenings and the presence of sleep-disordered breathing leads to increased sleep disturbance compared to patients having only 1 of the sleep disorders.",

keywords = "Comorbidity, Humans, Sleep, Sleep Apnea Syndromes/diagnosis, Sleep Apnea, Obstructive/complications, Sleep Initiation and Maintenance Disorders/complications, Sleep Wake Disorders/complications, COMISA, sleep structure, wakefulness, insomnia, awakenings, polysomnography, sleep apnea",

author = "Wulterkens, {Bernice M.} and Hermans, {Lieke W.A.} and Pedro Fonseca and Jerryll Asin and Nanny Duis and Janssen, {Hennie C.J.P.} and Sebastiaan Overeem and {van Gilst}, {Merel M.}",

year = "2023",

month = jun,

day = "1",

doi = "10.5664/jcsm.10500",

language = "English",

volume = "19",

pages = "1051--1059",

journal = "Journal of Clinical Sleep Medicine",

issn = "1550-9389",

publisher = "American Academy of Sleep Medicine",

number = "6",

}

TY - JOUR

T1 - Sleep structure in patients with COMISA compared to OSA and insomnia

AU - Wulterkens, Bernice M.

AU - Hermans, Lieke W.A.

AU - Fonseca, Pedro

AU - Asin, Jerryll

AU - Duis, Nanny

AU - Janssen, Hennie C.J.P.

AU - Overeem, Sebastiaan

AU - van Gilst, Merel M.

PY - 2023/6/1

Y1 - 2023/6/1

N2 - STUDY OBJECTIVES: Obstructive sleep apnea (OSA) and insomnia frequently co-occur, making diagnosis and treatment challenging. We investigated differences in sleep structure between patients with OSA, insomnia, and comorbid insomnia and sleep apnea (COMISA) to identify characteristics that can be used to improve the diagnosis of COMISA.METHODS: We obtained polysomnography data of 326 patients from the Sleep and OSA Monitoring with Non-Invasive Applications database. The group included patients with OSA (n = 199), insomnia (n = 47), and COMISA (n = 80). We compared statistics related to sleep structure between the 3 patient groups.RESULTS: Wake after sleep onset was significantly shorter for the OSA group (median: 60.0 minutes) compared to the COMISA (median: 83.3 minutes, P < .01) and the insomnia (median: 83.5 minutes, P = .01) groups. No significant differences were found in the total number of awakenings and the number of short (up to and including 2 minutes) and medium-length awakenings (2.5 up to and including 4.5 minutes). However, the number of long awakenings (5 minutes or longer) and wake after sleep onset containing only long awakenings was significantly lower for patients with OSA (median: 2 awakenings and 25.5 minutes) compared to patients with COMISA (median: 3 awakenings, P < .01 and 43.3 minutes, P < .001) or with insomnia (median: 3 awakenings, P < .01 and 56.0 minutes, P < .001). Total sleep time was significantly longer and sleep efficiency was significantly higher for the OSA group (median: 418.5 minutes and 84.4%) compared to both the COMISA (median: 391.5 minutes, P < .001 and 77.3%, P < .001) and the insomnia (median: 381.5 minutes, P < .001 and 78.2%, P < .001) groups. The number of sleep-stage transitions during the night for patients with COMISA (median: 194.0) was lower compared to that for patients with OSA (median: 218.0, P < .01) and higher compared to that for patients with insomnia (median: 156.0, P < .001). Other sleep architectural parameters were not discriminative between the groups. CONCLUSIONS: Patients with COMISA show specific characteristics of insomnia, including prolonged awakenings. This variable is distinctive in comparison to patients with OSA. The combination of prolonged awakenings and the presence of sleep-disordered breathing leads to increased sleep disturbance compared to patients having only 1 of the sleep disorders.

AB - STUDY OBJECTIVES: Obstructive sleep apnea (OSA) and insomnia frequently co-occur, making diagnosis and treatment challenging. We investigated differences in sleep structure between patients with OSA, insomnia, and comorbid insomnia and sleep apnea (COMISA) to identify characteristics that can be used to improve the diagnosis of COMISA.METHODS: We obtained polysomnography data of 326 patients from the Sleep and OSA Monitoring with Non-Invasive Applications database. The group included patients with OSA (n = 199), insomnia (n = 47), and COMISA (n = 80). We compared statistics related to sleep structure between the 3 patient groups.RESULTS: Wake after sleep onset was significantly shorter for the OSA group (median: 60.0 minutes) compared to the COMISA (median: 83.3 minutes, P < .01) and the insomnia (median: 83.5 minutes, P = .01) groups. No significant differences were found in the total number of awakenings and the number of short (up to and including 2 minutes) and medium-length awakenings (2.5 up to and including 4.5 minutes). However, the number of long awakenings (5 minutes or longer) and wake after sleep onset containing only long awakenings was significantly lower for patients with OSA (median: 2 awakenings and 25.5 minutes) compared to patients with COMISA (median: 3 awakenings, P < .01 and 43.3 minutes, P < .001) or with insomnia (median: 3 awakenings, P < .01 and 56.0 minutes, P < .001). Total sleep time was significantly longer and sleep efficiency was significantly higher for the OSA group (median: 418.5 minutes and 84.4%) compared to both the COMISA (median: 391.5 minutes, P < .001 and 77.3%, P < .001) and the insomnia (median: 381.5 minutes, P < .001 and 78.2%, P < .001) groups. The number of sleep-stage transitions during the night for patients with COMISA (median: 194.0) was lower compared to that for patients with OSA (median: 218.0, P < .01) and higher compared to that for patients with insomnia (median: 156.0, P < .001). Other sleep architectural parameters were not discriminative between the groups. CONCLUSIONS: Patients with COMISA show specific characteristics of insomnia, including prolonged awakenings. This variable is distinctive in comparison to patients with OSA. The combination of prolonged awakenings and the presence of sleep-disordered breathing leads to increased sleep disturbance compared to patients having only 1 of the sleep disorders.

KW - Comorbidity

KW - Humans

KW - Sleep

KW - Sleep Apnea Syndromes/diagnosis

KW - Sleep Apnea, Obstructive/complications

KW - Sleep Initiation and Maintenance Disorders/complications

KW - Sleep Wake Disorders/complications

KW - COMISA

KW - sleep structure

KW - wakefulness

KW - insomnia

KW - awakenings

KW - polysomnography

KW - sleep apnea

UR - http://www.scopus.com/inward/record.url?scp=85173572028&partnerID=8YFLogxK

U2 - 10.5664/jcsm.10500

DO - 10.5664/jcsm.10500

M3 - Article

C2 - 36740913

SN - 1550-9389

VL - 19

SP - 1051

EP - 1059

JO - Journal of Clinical Sleep Medicine

JF - Journal of Clinical Sleep Medicine

IS - 6

ER -

Sleep structure in patients with COMISA compared to OSA and insomnia

Samenvatting

Financiering

Toegang tot document

Andere bestanden en links

Vingerafdruk

Impact

Sleep Medicine

Citeer dit