Clinical and Polysomnographic Characteristics of Comorbid Insomnia and Sleep Apnoea: Findings From the TURKAPNE Cohort

ABSTRACT

Insomnia symptoms are frequently reported by patients with obstructive sleep apnoea (OSA). We aimed to estimate the prevalence of co‐occurring insomnia symptoms and OSA and to characterize its clinical, comorbidity and polysomnographic profile in a nationwide sleep clinic population. We analysed data from 12,715 adults enrolled in the multicentre Turkish Sleep Apnoea Database (TURKAPNE). All participants underwent full‐night laboratory‐based polysomnography and completed standardized symptom questionnaires. Participants were categorized into four groups: OSA with co‐occurring insomnia symptoms, OSA only, insomnia symptoms only and a reference group with neither OSA nor insomnia symptoms. Multivariable logistic regression analyses were performed to evaluate symptom associations across groups. Of 12,715 participants, 8142 (64.0%) had OSA only, 3275 (25.8%) had OSA with co‐occurring insomnia symptoms, 388 (3.1%) had insomnia symptoms only and 910 (7.2%) constituted the reference group. Compared with the reference group, OSA with co‐occurring insomnia symptoms was strongly associated with nocturnal dyspnoea (aOR 3.94, 95% CI 3.07–5.04), morning headache (aOR 3.31, 95% CI 2.46–4.44) and depressed mood (aOR 3.01, 95% CI 2.20–4.13). Polysomnography demonstrated respiratory disturbance together with prolonged sleep latency and a higher arousal index in participants with OSA and co‐occurring insomnia symptoms. To conclude, in this large national sleep clinic cohort, OSA with co‐occurring insomnia symptoms was common and associated with greater clinical complexity and combined respiratory and sleep‐continuity disturbances. Systematic assessment of insomnia symptoms in patients evaluated for OSA may improve clinical characterization and support more integrated management approaches.

Trial Registration: NCT02784977