High Mortality Risk Associated with Insomnia and Obstructive Sleep Apnea

People who report co-morbid insomnia and high-risk obstructive sleep apnea (OSA) may have an increased risk of death, according to a recent study.

The researchers investigated the association between co-morbid insomnia and OSA as both are prevalent conditions with negative health outcomes.

Data was used from the National Health and Nutrition Examination Survey between 2005 and 2008 (n = 6877). For the study, insomnia was defined as persons having trouble initiating sleep, long awakenings, and/or early morning awakenings on 16 and more nights per month with daytime impairment. Participants at high-risk of OSA were identified through the Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass Index, Age, Neck circumference, and Gender (STOP-Bang) questionnaire. People with both conditions were included in the co-morbid insomnia and sleep apnea (COSMIA) group.

Of the total participants, 73.5% had neither condition, 20.1% had only OSA, 3.0% had insomnia only, and 3.3% had COMISA. A higher mortality risk was observed in participants with COMISA (HR 1.9; 95% CI, = 1.3 – 2.8) and insomnia alone (HR 1.5; 95% CI, 1.0 – 2.3) when compared with participants with neither condition after adjusting for confounding factors. At an 11-year follow-up, 6.7% of the total participants died.

Furthermore, the relationship between COMISA and mortality continued after the researchers controlled the data for chronic conditions, sleep duration, and sleeping pill use (HR 1.6; 95% CI, 1.1 – 2.3). The relationship between insomnia-alone and mortality did not persist (HR 1.4; 95% CI, 0.9 – 2.3).

“Clinicians can screen patients for COMISA symptoms with existing validated self-report questionnaires” the researchers concluded. “It is important to develop more effective and tailored management approaches for COMISA, and to investigate the effect of COMISA treatment on reduction of mortality risk.”

—Jessica Ganga

Reference:

Sweetman A, Lechat B, Appleton S, et al. Association of co-morbid insomnia and sleep apnoea symptoms with all-cause mortality: analysis of the NHANES 2005-2008 data. Sleep Epidemiology. Published online August 11, 2002. doi:10.1016/j.sleepe.2022.100043