Diabetes mellitus is associated with increased prevalence and severity of COMISA: evidence from the nationwide TURKAPNE cohort.

IF 3.4 3区医学 Q1 CLINICAL NEUROLOGY

Journal of Clinical Sleep Medicine Pub Date : 2026-07-02 DOI:10.1007/s44470-026-00109-4

Canan Gündüz Gürkan, Aylin Pihtili, Esen Kiyan, Mehmet Sezai Tasbakan, Özen K Basoglu, Semih Arbatli, Senay Aydin, Aykut Cilli, Neşe Dursunoglu, Burcu Baran, Yüksel Peker

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Abstract

Background: Comorbid insomnia and obstructive sleep apnea (COMISA) is increasingly recognized as a clinically important sleep disorder phenotype with potential cardiometabolic consequences. However, its association with diabetes mellitus (DM) remains insufficiently characterized.

Methods: This cross-sectional analysis included 12,715 adults with suspected obstructive sleep apnea (OSA) from the nationwide multicenter TURKAPNE cohort who underwent full-night polysomnography. Insomnia symptoms were assessed using standardized questionnaire items, and OSA was defined as apnea-hypopnea index (AHI) ≥ 5 events/hour. COMISA was defined as the coexistence of insomnia symptoms and OSA. DM was identified based on self-reported physician diagnosis or use of antidiabetic medications. Multivariable logistic regression was performed to evaluate independent variables associated with COMISA.

Results: COMISA was present in 3,275 patients (25.7%). DM was significantly more prevalent among patients with COMISA compared with those without COMISA (22.8% vs. 15.4%, p < 0.001). Overall, COMISA was observed in 33.9% of diabetic individuals and 24.1% of non-diabetic individuals. In multivariable analysis adjusted for age, sex, body-mass-index, smoking status, education level, and comorbidities, DM remained independently associated with COMISA (adjusted OR 1.17; 95% CI 1.05-1.31; p = 0.006). Among COMISA patients, those with DM exhibited greater sleep fragmentation and more severe sleep-disordered breathing, including higher AHI (30.0 vs. 24.0 events/h) and oxygen desaturation index (26.0 vs. 20.0 events/h) (p < 0.001).

Conclusions: DM is independently associated with COMISA and with more severe sleep and respiratory disturbances within this phenotype. These findings highlight the need for integrated screening of sleep disorders in individuals with DM.

Trial registration: ClinicalTrials gov (NCT02784977).

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糖尿病与COMISA的患病率和严重程度增加有关：来自全国TURKAPNE队列的证据

背景：共病性失眠和阻塞性睡眠呼吸暂停（COMISA）越来越被认为是临床上重要的睡眠障碍表型，具有潜在的心脏代谢后果。然而，其与糖尿病（DM）的关系仍然没有充分的特征。方法：这项横断面分析包括来自全国多中心TURKAPNE队列的12715名疑似阻塞性睡眠呼吸暂停（OSA）的成年人，他们接受了整夜多导睡眠图检查。采用标准化问卷项目评估失眠症状，将OSA定义为呼吸暂停低通气指数(AHI)≥5次/小时。COMISA定义为失眠症状和OSA共存。糖尿病是根据自我报告的医师诊断或使用抗糖尿病药物来确定的。采用多变量logistic回归评价与COMISA相关的自变量。结果：3275例（25.7%）患者存在COMISA。与没有COMISA的患者相比，糖尿病在COMISA患者中更为普遍（22.8% vs 15.4%）， p结论：DM与COMISA独立相关，并且在该表型中伴有更严重的睡眠和呼吸障碍。这些发现强调了对患有睡眠障碍的个体进行综合筛查的必要性。试验注册：ClinicalTrials gov （NCT02784977）。

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

Journal of Clinical Sleep Medicine CLINICAL NEUROLOGY-

CiteScore

6.20

自引率

7.00%

发文量

321

审稿时长

1 months

期刊介绍： Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.