Sleep and Breathing最新文献

{"title":"Prevalence of continuous positive airway pressure-related aerophagia in obstructive sleep apnea: an observational study of 753 cases undergoing CPAP/BiPAP treatment in a sleep clinic - part one of a two-part series.","authors":"Takero Fukutome","doi":"10.1007/s11325-024-03152-8","DOIUrl":"https://doi.org/10.1007/s11325-024-03152-8","url":null,"abstract":"<p><strong>Purpose: </strong>Aerophagia occurring during continuous positive airway pressure (C-aerophagia in CPAP) in patients with obstructive sleep apnea (OSA) disturbs CPAP therapy. However, the diagnostic criteria and exact prevalence of C-aerophagia are not well documented; therefore, this study aimed to evaluate them.</p><p><strong>Methods: </strong>Newly developed criteria (flatulence, eructation, and abdominal bloating, with quantitative evaluation of these symptoms and a clear timing of onset) were used to diagnose C-aerophagia. The study included 753 adults with OSA who underwent follow-up visits for positive airway pressure treatment (including CPAP and bilevel positive airway pressure). The observation period ranged from 6 months to 3 years past the survey date (between May 1 and July 31, 2023). Medical records of patients were retrospectively analyzed. Discomfort associated with C-aerophagia was examined using a visual analog scale (VAS); a score ≥ 7 was associated with definite discomfort. Association of patient demographics and CPAP parameters with occurrence of C-aerophagia was analyzed using multivariate analysis.</p><p><strong>Results: </strong>The prevalence of C-aerophagia was 7.2%. Although more than half of these patients reported discomfort associated with aerophagia, only 44.4% reported to their physician. The multivariate analysis showed that increased CPAP pressure level (odds ratio [OR] = 1.24) and comorbid gastroesophageal reflux disease (GERD; OR = 2.52) promote C-aerophagia, while increased age (OR = 0.76) and body mass index (BMI; OR = 0.88) inhibit it.</p><p><strong>Conclusion: </strong>The prevalence of C-aerophagia was 7.2%. Most patients with C-aerophagia experience discomfort, but may not report these symptoms. High CPAP pressure and GERD promoted C-aerophagia, while aging and increased BMI prevented it.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on OSA screening and influencing factors in community-based elderly hypertensive patients based on single-lead wearable ECG devices.","authors":"Xinyan Yu, Linger Guan, Peng Su, Qinghong Zhang, Xuan Guo, Ting Li, Jing Zhang, Yongli Ji, Haicheng Zhang","doi":"10.1007/s11325-024-03136-8","DOIUrl":"https://doi.org/10.1007/s11325-024-03136-8","url":null,"abstract":"<p><strong>Purpose: </strong>Assessing whether single-lead ECG can be effectively and relatively inexpensively used in large-scale OSA screening, and identifying factors influencing moderate-to-severe OSA among elderly hypertensive patients without atypical symptoms in primary care.</p><p><strong>Methods: </strong>The study gathered data from 15 medical institutions in Ningxia between January and December 2022 using cloud platforms. The dataset included basic information and 72-h ECG monitoring for 2573 hypertensive patients over 65. OSA screening was conducted using the single-lead wearable ECG devices based on the ACAT algorithm. A multivariable logistic regression identified the main factors affecting OSA severity in these patients, and the AUC was used to assess the model's predictive accuracy.</p><p><strong>Results: </strong>The study found an OSA detection rate of 87.10%, with 55.42% being moderate to severe cases. Key risk factors associated with developing moderate-to-severe OSA included cardiac irregularities like supraventricular extrasystole and atrioventricular block, male gender, lifestyle factors like alcohol consumption and smoking, and health indicators such as SDNN ≤ 100 ms, abnormal LF/HF ratio, BMI, and age. The model's accuracy for predicting OSA, indicated by a ROAUC of 0.625, was moderate. Factors like gender, tea consumption, stroke history, and ventricular tachycardia were also independently linked to OSA severity.</p><p><strong>Conclusion: </strong>This study combines single-lead wearable ECG devices with the ACAT algorithm for OSA screening in Ningxia, China. Initial screening identified 87.10% of participants as having OSA, with 55.42% being moderate to severe cases. This suggests a convenient, low-cost, and repeatable ECG-based method for OSA screening, potentially improving early detection and management of OSA by identifying potential risk factors.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and evaluation of a predictive model for the types of sleep respiratory events in patients with OSA based on hypoxic parameters.","authors":"Cheng Peng, Shaorong Xu, Yan Wang, Baoyuan Chen, Dan Liu, Yu Shi, Jing Zhang, Zhongxing Zhou","doi":"10.1007/s11325-024-03147-5","DOIUrl":"https://doi.org/10.1007/s11325-024-03147-5","url":null,"abstract":"<p><strong>Objective: </strong>To explore the differences and associations of hypoxic parameters among distinct types of respiratory events in patients with obstructive sleep apnea (OSA) and to construct prediction models for the types of respiratory events based on hypoxic parameters.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on a cohort of 67 patients with polysomnography (PSG). All overnight recorded respiratory events with pulse oxygen saturation (SpO₂) desaturation were categorized into four categories: hypopnea (Hyp, 3409 events), obstructive apnea (OA, 5561 events), central apnea (CA, 1110 events) and mixed apnea (MA, 1372 events). All event recordings were exported separately from the PSG software as comma-separated variable (.csv) files, which were imported into custom-built MATLAB software for analysis. Based on 13 hypoxic parameters, artificial neural network (ANN) and binary logistic regression (BLR) were separately used for construction of Hyp, OA, CA and MA models. Receiver operating characteristic (ROC) curves were employed to compare the various predictive indicators of the two models for different respiratory event types, respectively.</p><p><strong>Results: </strong>Both ANN and BLR models suggested that 13 hypoxic parameters significantly influenced the classification of respiratory event types; The area under the ROC curves of the ANN models surpassed those of traditional BLR models respiratory event types.</p><p><strong>Conclusion: </strong>The ANN models constructed based on the 13 hypoxic parameters exhibited superior predictive capabilities for distinct types of respiratory events, providing a feasible new tool for automatic identification of respiratory event types using sleep SpO₂.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote monitoring system to support positive airway pressure therapy in patients with obstructive sleep apnea: a multi-center randomized controlled trial.","authors":"Shokoufeh Aalaei, Hamed Tabesh, Hadi Shahraki, Fariborz Rezaeitalab, Mahnaz Amini, Lahya Afsharisaleh, Hadi Asadpour, Saeid Eslami","doi":"10.1007/s11325-024-03108-y","DOIUrl":"https://doi.org/10.1007/s11325-024-03108-y","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and evaluate an intervention tailored to patients' needs to increase the rate of positive airway pressure (PAP) adherence in patients afflicted with obstructive sleep apnea (OSA), who undergo PAP therapy.</p><p><strong>Methods: </strong>A multi-center, 3 parallel-arm, randomized, controlled trial was conducted. Participants with OSA who undergo a PAP therapy were randomized to one of three groups: control arm (usual care), educational booklet arm, and mobile-based application arm. PAP usage, the percentage of days using the device for more than 4 h, change in knowledge, risk perception, outcome expectancy, self-efficacy, and ESS were assessed before and one month after interventions in the three groups. Also, the application usage data were analyzed.</p><p><strong>Results: </strong>The result showed the change in average PAP usage, knowledge, risk perception, and self-efficacy in the application group was significantly higher than the control and booklet groups. Also, the change in use for more than 4 h in the application group was significantly higher than the control group. Comparing the actual and patients' self-report PAP use indicated patients' self-report about the use of the device is about 50 min (0.8 h) more than the actual amount of use.</p><p><strong>Conclusion: </strong>The study results indicated that the improvement of primary and secondary outcomes in adherence to PAP was significantly higher in the application group than in other study groups. Given the increasingly penetrating influence of smartphone-based technologies, it seems that mobile-based applications could potentially be adopted in the population of patients with OSA.</p><p><strong>Clinical trials registration: </strong>IRCT2017092236314N1; https://en.irct.ir/trial/27185.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of snoring on pregnant women and fetal outcomes: a cross sectional study.","authors":"Biying Wang, Jianming Zhao, Lifang Fu, Caiyun Wang, Meixin Nian, Xuefen Cai, Jiefeng Huang","doi":"10.1007/s11325-024-03098-x","DOIUrl":"https://doi.org/10.1007/s11325-024-03098-x","url":null,"abstract":"<p><strong>Purpose: </strong>Snoring frequently occurs among pregnant women, particularly in the later stages of pregnancy. It often signals obstructive sleep apnea (OSA), which could potentially affect pregnancy outcomes negatively. Hence, our study aimed to investigate how snoring influences the likelihood of pregnancy complications and fetal outcomes in a cohort of expectant mothers.</p><p><strong>Methods: </strong>We enrolled pregnant women in their second and third trimesters and had them fill out a questionnaire concerning sleep-related symptoms such as snoring, excessive daytime sleepiness, and frequency of nighttime awakenings, along with anthropometric measurements. Subsequently, the participants were divided into snorers and non-snorers, and the occurrence of pregnancy complications and fetal outcomes was monitored.</p><p><strong>Results: </strong>The study enrolled a total of 212 pregnant women, among whom 35 were identified as snorers and 177 as non-snorers during mid to late pregnancy. This indicated a snoring prevalence of 16.5% in our sample. Significant differences were noted between the two groups regarding the occurrence of oligohydramnios (11.43% vs. 2.82%, p = 0.044) and fetal distress (28.57% vs. 8.47%, p = 0.003). Logistic regression analyses revealed that snoring was independently associated with fetal distress (odds ratio [OR] = 4.99, 95% confidence interval [CI] 1.88-13.23, p = 0.001).</p><p><strong>Conclusions: </strong>Our findings suggest that habitual snoring was the independent risk factor fetal distress after adjusting for potential confounders, indicating that habitual snoring may have a detrimental effect during mid to late pregnancy.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic adherence in patients with Obstructive Sleep Apnea Syndrome: a retrospective cohort study.","authors":"Carmen Samà, Sandro Longu, Giorgio Bergesio, Francesca Samà, Alessia Faioli","doi":"10.1007/s11325-024-03097-y","DOIUrl":"https://doi.org/10.1007/s11325-024-03097-y","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory disorder characterized by repeated episodes of partial or complete airway obstruction. Continuous Positive Airway Pressure therapy (CPAP) is effective in improving sleep quality and daytime sleepiness. The aim of the study was to evaluate therapeutic adherence in a sample of patients with OSAS from the Pneumology ward of the \"Cardinal Massaia\" Hospital in Asti.</p><p><strong>Materials and methods: </strong>A sample of 221 patients with OSAS were collected and retrospectively analyzed from January 2019 to December 2021. Ventilation hours during device titration (T1), possible second titration (T2) and one-year control (T3) were considered. The use of the CPAP device equal to or greater than 4 h/night was considered as therapeutic adherence. Age, gender, severity of OSAS, smoking, interface used and Epworth Sleepiness Scale (ESS) score were considered.</p><p><strong>Results: </strong>The analysis data showed that the percentage of adhesion during T1 was 84%. Only 9% needed T2, with 84% adherence. At T3 the adherence was 86%. Correlation studies showed that only smoking had a positive correlation with adherence, while OSAS severity, gender, ESS score, interface used and age had no statistically significant correlation.</p><p><strong>Conclusion: </strong>It was important to understand that OSAS is a disease with prolonged treatment, which affects the life of the person and his family. Therefore, the concept of assistance network was born, which sees the healthcare operators, the person and his family as the main actors involved in a care process.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor sleep duration and E-cigarette/Cigarette use among US adults with cardiovascular diseases: findings from the 2022 BRFSS cross-sectional study.","authors":"Wei Li, Mohammad Ebrahimi Kalan, Anthony J Kondracki, Prem Gautam, Rime Jebai, Olufemi Erinoso, Olatokunbo Osibogun","doi":"10.1007/s11325-024-03140-y","DOIUrl":"https://doi.org/10.1007/s11325-024-03140-y","url":null,"abstract":"<p><strong>Background: </strong>Studies have explored the connections between tobacco use, sleep and cardiovascular disease (CVD) risks in adults, but no study has examined the link between tobacco use and sleep among adults with CVDs. This study explores the association between tobacco use (cigarette only, e-cigarette only, and dual use) and poor sleep duration among adults with CVDs.</p><p><strong>Methods: </strong>A sample of 47,180 US adults with CVDs (myocardial infarction, coronary heart disease, or stroke) was drawn from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional survey. Poor/inadequate sleep (< 7 h/24-hour) was defined based on National Sleep Foundation recommendations. Logistic regression models assessed tobacco use status across seven categories (i.e., non-use [reference], current [past-month use] cigarette only, current e-cigarettes only, current dual use, former cigarette only, former e-cigarette only, and former dual use) with inadequate sleep, adjusting for demographics and health conditions.</p><p><strong>Results: </strong>Overall, 40% of US adults with a history of CVD reported inadequate sleep. Current cigarette, e-cigarette, and dual use were associated with a relatively higher proportion of inadequate sleep duration. Unweighted findings revealed a significant association between current cigarette use (OR = 1.35, 95%CI: 1.26-1.44), e-cigarette use (1.40 [1.19-1.63]) and dual use (1.50 [1.27-1.77]) and increased odds of reporting inadequate sleep among adults with CVDs. Weighted analysis showed only a significant link between current cigarette use and inadequate sleep (1.34 [1.17-1.54]).</p><p><strong>Conclusions: </strong>Current cigarette use is associated with poor sleep in adults with CVDs. Unweighted findings suggested a similar association for e-cigarettes. Interventions targeting smoking cessation may offer promising avenues for improving sleep health and reducing the burden on adults with CVDs.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing probabilistic ensemble machine learning models for home-based sleep apnea screening using overnight SpO2 data at varying data granularity.","authors":"Zilu Liang","doi":"10.1007/s11325-024-03141-x","DOIUrl":"https://doi.org/10.1007/s11325-024-03141-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop sleep apnea screening models with overnight SpO2 data, and to investigate the impact of the SpO2 data granularity on model performance.</p><p><strong>Methods: </strong>A total of 7,718 SpO2 recordings from the SHHS and MESA datasets were used. Probabilistic ensemble machine learning was employed to predict sleep apnea status at three AHI cutoff points: ≥ 5, ≥ 15, and ≥ 30 events/hour. To investigate the impact of data granularity, SpO2 data were aggregated at 30, 60, and 300 s.</p><p><strong>Results: </strong>Our models demonstrated good to excellent performance on internal test, with average area under the curve (AUC) values of 0.91, 0.93, and 0.96 for cutoffs ≥ 5, ≥ 15, and ≥ 30 at data granularity of 1 s, respectively. Both sensitivity (0.76, 0.84, 0.89) and specificity (0.87, 0.86, 0.90) ranged from good to excellent across three cutoffs. Positive predictive values (PPV) ranged from excellent to fair (0.97, 0.83, 0.66), and negative predictive values (NPV) ranged from low to excellent (0.43, 0.87, 0.98). Model performance on external test slightly dropped compared to internal test, but still achieved good to excellent AUC above 0.80 across all data granularity and all the three cutoffs. Data granularity of 300 s led to a reduction in performance metrics across all cutoffs.</p><p><strong>Conclusion: </strong>Our models demonstrated superior performance across all three AHI cutoff thresholds compared to existing large sleep apnea screening models, even when considering varying SpO2 data granularity. However, lower data granularity was associated with decreased screening performance, indicating a need for further research in this area.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep conditions and sleep hygiene behaviors in early pregnancy are associated with gestational diabetes mellitus: A propensity-score matched study.","authors":"Guojun Ma, Yanqing Cai, Yong Zhang, Jianxia Fan","doi":"10.1007/s11325-024-03071-8","DOIUrl":"https://doi.org/10.1007/s11325-024-03071-8","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the influence of sleep conditions and sleep hygiene behaviors in early pregnancy on gestational diabetes mellitus (GDM) development.</p><p><strong>Methods: </strong>This 1:1 propensity-score matched study included 1,216 pregnant women divided into GDM and control groups based on diagnosis via the oral glucose tolerance test at 24-28 gestational weeks. Sleep conditions and hygiene behaviors were evaluated using structural questionnaires, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Sleep Hygiene Practice Scale. Univariate and multivariate logistic regression analyses and Spearman's correlation were conducted to identify the associations.</p><p><strong>Results: </strong>After adjusting for baseline clinical characteristics, women with GDM were more likely to have poor sleep quality (adjusted odds ratio [AOR] = 1.585, 95% confidence interval [CI]: 1.261-1.992) and higher scores for subjective sleep quality, latency, duration, efficiency, and sleep disturbances (all P < 0.01). Mild sleepiness (AOR = 1.311, 95% CI: 1.012-1.699) and worrying about not being able to fall asleep (AOR = 1.123, 95% CI: 1.005-1.255) were more likely to occur in the GDM group. Sleep quality and hygiene behaviors such as sleep-irrelevant activities, staying in bed after waking up, weekend catch-up sleep, and overeating before bedtime were significantly correlated with gestational diabetes variables.</p><p><strong>Conclusion: </strong>Poor sleep conditions and specific sleep hygiene behaviors in early pregnancy may be independent risk factors for GDM. This suggests that sleep assessment and behavior education can be used as new approaches for the early implementation of surveillance and prevention of GDM.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-morbid Insomnia and Sleep Apnea (COMISA) in a large sample of Iranian: prevalence and associations in a sleep clinic population.","authors":"Habibolah Khazaie, Mirza Aghazadeh, Ali Zakiei, Soroush Maazinezhad, Azita Tavallaie, Behrouz Moghbel, Mehrnaz Azarian, Farina Mozafari, Ebrahim Norouzi, Alexander Sweetman, Amir Sharafkhaneh","doi":"10.1007/s11325-024-03102-4","DOIUrl":"https://doi.org/10.1007/s11325-024-03102-4","url":null,"abstract":"<p><strong>Background: </strong>Sleep apnea (SA) and insomnia (INS) are prevalent sleep disorders among referrals to sleep clinics. People with comorbid insomnia and sleep apnea (COMISA) suffer both disorders simultaneously. The epidemiology of COMISA is not well known in the Middle East including Iran. We hypothesized that COMISA is prevalent in metropolitan sleep clinic cohorts in Iran.</p><p><strong>Method: </strong>The records of patients aged < 95 years referred to sleep disorders centers in four large metropolitan areas including Kermanshah, Tabriz, Shiraz, and Ahvaz were examined. Polysomnography (PSG) was performed in all these patients in specialized centers and the results were scored by a trained technician and interpreted by a sleep specialist. SA was defined as an Apnea-Hypopnea Index (AHI ≥ 5), INS was defined by psychiatrists according to self-report and clinical interviews, and COMISA was defined if both disorders were present. Participants with neither condition were included in as comparator group. One-way ANOVAs, correlation, and linear/logistic regression analyses were used.</p><p><strong>Results: </strong>This study included 1807 patients (Mean age 49.3, SE ± 13.7; 38.8% Female). Comparator, INS, SA and COMISA made up 7.2%, 16%, 50.2% and 26.6% of the sample, respectively. Logistic regression analyses showed that male gender, older age, and increasing neck circumference, but not BMI, were associated with COMISA. Epworth Sleepiness Scale scores were lower in INS (5.39 ± 5.78) compared to the other three groups.</p><p><strong>Conclusion: </strong>COMISA is a prevalent condition in metropolitan sleep centers in Iran among participants referred to sleep centers. The data showed that male gender and age were associated significantly with COMISA.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}