Prevalence and clinical significance of comorbid insomnia and sleep apnea (COMISA) in three population-based cohorts from Benin, Switzerland and India

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-04-18 DOI:10.1016/j.sleep.2025.106526

Geoffroy Solelhac , Ablo Prudence Wachinou , Abhishek Goyal , Théo Imler , Abhijit Pakhare , Amit Kumar Sen , Jose Haba-Rubio , Gregory Heiniger , Adrien Waeber , Peter Vollenweider , Pedro Marques-Vidal , Sandra Van Den Broecke , Roch Christian Johnson , Pierre-Marie Preux , Nicola Andrea Marchi , Raphaël Heinzer

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Abstract

Introduction

COMISA is defined as a comorbid condition comprising insomnia and obstructive sleep apnea (OSA). This study aims to assess the prevalence of COMISA and its association with cardiovascular risk factors within three population-based cohorts from Benin (BeSAS, n = 1733), Switzerland (HypnoLaus, n = 1999), and India (BLESS, n = 958).

Methods

OSA was assessed by nocturnal recordings, while the presence of insomnia symptoms was assessed by questionnaires in the three cohorts. Adjusted logistic regression models were employed to assess the associations of COMISA with hypertension, diabetes and metabolic syndrome. These associations were also examined using different COMISA definitions based on insomnia subtypes (initiation difficulties and early morning awakenings/maintenance difficulties).

Results

The crude prevalence of COMISA was 11.4 % in HypnoLaus, 9.1 % in BLESS and 1.7 % in BeSAS. In HypnoLaus, COMISA showed a trend towards an association with hypertension (OR: 1.34, p = 0.09) and metabolic syndrome (OR: 1.37, p = 0.09), which was statistically significant when insomnia was defined by sleep initiation difficulties. In BLESS, COMISA was significantly associated with both hypertension (OR: 3.30, p < 0.001) and metabolic syndrome (OR: 1.1.71, p = 0.008). No significant associations were observed in BeSAS.

Conclusion

COMISA has a high prevalence worldwide and may be associated with hypertension and metabolic syndrome.

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来自贝宁、瑞士和印度的三个人群队列中共病性失眠和睡眠呼吸暂停（COMISA）的患病率及临床意义

comisa被定义为包括失眠和阻塞性睡眠呼吸暂停（OSA）的合并症。本研究旨在评估COMISA的患病率及其与心血管危险因素的关系，研究对象为三个基于人群的队列，分别来自贝宁（BeSAS, n = 1733）、瑞士（HypnoLaus, n = 1999）和印度（BLESS, n = 958）。方法采用夜间记录的方法评估患者的睡眠质量，采用问卷调查的方法评估患者是否出现失眠症状。采用调整后的logistic回归模型评估COMISA与高血压、糖尿病和代谢综合征的关系。这些关联还使用基于失眠亚型（开始困难和清晨醒来/维持困难）的不同COMISA定义进行了检查。结果COMISA粗患病率在HypnoLaus组为11.4%，BLESS组为9.1%，BeSAS组为1.7%。在失眠患者中，COMISA表现出与高血压（OR: 1.34, p = 0.09）和代谢综合征（OR: 1.37, p = 0.09）相关的趋势，当失眠被定义为睡眠启动困难时，这一趋势具有统计学意义。在BLESS中，COMISA与高血压(OR: 3.30, p <；0.001)和代谢综合征（OR: 1.1.71, p = 0.008）。在BeSAS中未观察到显著相关性。结论comisa在世界范围内具有较高的患病率，可能与高血压和代谢综合征有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.