Polysomnographic Characteristics of Insomnia Patients with Comorbid Obstructive Sleep Apnea-hypopnea Syndrome_West China Medical Journal

Authors：

 LeiFei , RenRong , DuLina ,  TangXiangdong

Sleep Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

TangXiangdong, Email: Xiangdong.tang@gmail.com

Keywords：

Sleep apnea; obstructive; Insomnia; Polysomnography

DOI：

10.7507/1002-0179.201600363

Video：

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Objective To assess the polysomnographic characteristics of insomnia patients with comorbid obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods We performed a comparative analysis on the polysomnographic features among patients with pure insomnia (n=80), patients with pure OSAHS (n=80), and patients with insomnia and OSAHS (n=50) between August and December 2013. Results Compared with OSAHS group, patients with insomnia and comorbid OSAHS had a higher percentage of female, older age, lower body mass index, shorter total sleep time during the night, longer sleep latent period and wake after sleep onset (WASO), lower sleep efficacy, lower arousal index and apnea hypoventilation index (AHI), higher average and the lowest oxygen saturation of blood, lower Epworth Sleepiness Scale scores and sleep perception (P < 0.05). Compared with the insomnia group, patients with insomnia and comorbid OSAHS had a lower percentage of female, shorter total sleep time, lower sleep efficacy, longer WASO and higher AHI (P < 0.05). Conclusion Patients with insomnia and comorbid OSAHS have all the characteristics of insomnia and OSAHS patients:nocturnal hypoxia, sleep fragmentation, broken sleep continuity, decreased sleep efficiency, damaged perception of sleep time and sleep perception.

Citation： LeiFei, RenRong, DuLina, TangXiangdong. Polysomnographic Characteristics of Insomnia Patients with Comorbid Obstructive Sleep Apnea-hypopnea Syndrome. West China Medical Journal, 2016, 31(8): 1321-1324. doi: 10.7507/1002-0179.201600363 Copy

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6.	Subramanian S, Guntupalli B, Murugan T, et al. Gender and ethnic differences in prevalence of self-reported insomnia among patients with obstructive sleep apnea[J]. Sleep Breath, 2011, 15(4):711-715.
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8.	Huang L, Zhou J, Li Z, et al. Sleep perception and the multiple sleep latency test in patients with primary insomnia[J]. J Sleep Res, 2012, 21(6):684-692.
9.	Lee MH, Lee SA, Lee GH, et al. Gender differences in the effect of comorbid insomnia symptom on depression, anxiety, fatigue, and daytime sleepiness in patients with obstructive sleep apnea[J]. Sleep Breath, 2014, 18(1):111-117.
10.	Huang L, Zhou J, Sun Y, et al. Polysomnographically determined sleep and body mass index in patients with insomnia[J]. Psychiatry Res, 2013, 209(3):540-544.
11.	Krakow B, Melendrez D, Sisley B, et al. Nasal dilator strip therapy for chronic sleep-maintenance insomnia and symptoms of sleep-disordered breathing:a randomized controlled trial[J]. Sleep Breath, 2006, 10(1):16-28.
12.	Krakow B, Melendrez D, Lee SA, et al. Refractory insomnia and sleep-disordered breathing:a pilot study[J]. Sleep Breath, 2004, 8(1):15-29.
13.	Luyster FS, Buysse DJ, Strollo PJ, et al. Comorbid insomnia and obstructive sleep apnea:challenges for clinical practice and research[J]. J Clin Sleep Med, 2010, 6(2):196-204.
14.	Neckelmann D, Mykletun A, Dahl AA. Chronic insomnia as a risk factor for developing anxiety and depression[J]. Sleep, 2007, 30(7):873-880.
15.	Krell SB, Kapur VK. Insomnia complaints in patients evaluated for obstructive sleep apnea[J]. Sleep Breath, 2005, 9(3):104-110.

1. Punjabi NM. The epidemiology of adult obstructive sleep apnea[J]. Proc Am Thorac Soc, 2008, 5(2):136-143.
2. Cho YW, Shin WC, Yun CH, et al. Epidemiology of insomnia in korean adults:prevalence and associated factors[J]. J Clin Neurol, 2009, 5(1):20-23.
3. Chung KF. Insomnia subtypes and their relationships to daytime sleepiness in patients with obstructive sleep apnea[J]. Respiration, 2005, 72(5):460-465.
4. Krakow B, Melendrez D, Ferreira E, et al. Prevalence of insomnia symptoms in patients with sleep-disordered breathing[J]. Chest, 2001, 120(6):1923-1929.
5. Smith S, Sullivan K, Hopkins W, et al. Frequency of insomnia report in patients with obstructive sleep apnoea hypopnea syndrome (OSAHSHS)[J]. Sleep Med, 2004, 5(5):449-456.
6. Subramanian S, Guntupalli B, Murugan T, et al. Gender and ethnic differences in prevalence of self-reported insomnia among patients with obstructive sleep apnea[J]. Sleep Breath, 2011, 15(4):711-715.
7. Kessler RC, McGonagle KA, Swartz M, et al. Sex and depression in the National Comorbidity Survey.Ⅰ:llifetime prevalence, chronicity and recurrence[J]. J Affect Disord, 1993, 29(2/3):85-96.
8. Huang L, Zhou J, Li Z, et al. Sleep perception and the multiple sleep latency test in patients with primary insomnia[J]. J Sleep Res, 2012, 21(6):684-692.
9. Lee MH, Lee SA, Lee GH, et al. Gender differences in the effect of comorbid insomnia symptom on depression, anxiety, fatigue, and daytime sleepiness in patients with obstructive sleep apnea[J]. Sleep Breath, 2014, 18(1):111-117.
10. Huang L, Zhou J, Sun Y, et al. Polysomnographically determined sleep and body mass index in patients with insomnia[J]. Psychiatry Res, 2013, 209(3):540-544.
11. Krakow B, Melendrez D, Sisley B, et al. Nasal dilator strip therapy for chronic sleep-maintenance insomnia and symptoms of sleep-disordered breathing:a randomized controlled trial[J]. Sleep Breath, 2006, 10(1):16-28.
12. Krakow B, Melendrez D, Lee SA, et al. Refractory insomnia and sleep-disordered breathing:a pilot study[J]. Sleep Breath, 2004, 8(1):15-29.
13. Luyster FS, Buysse DJ, Strollo PJ, et al. Comorbid insomnia and obstructive sleep apnea:challenges for clinical practice and research[J]. J Clin Sleep Med, 2010, 6(2):196-204.
14. Neckelmann D, Mykletun A, Dahl AA. Chronic insomnia as a risk factor for developing anxiety and depression[J]. Sleep, 2007, 30(7):873-880.
15. Krell SB, Kapur VK. Insomnia complaints in patients evaluated for obstructive sleep apnea[J]. Sleep Breath, 2005, 9(3):104-110.

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