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Abstract Introduction Sleep apnea and insomnia often co-occur in older adults, complicating treatment and worsening outcomes. More research is needed to characterize sleep apnea patients with and without co-morbid insomnia. We characterized differences in demographic and clinical characteristics between individuals with co-morbid insomnia and sleep apnea (COMISA) and those with sleep apnea alone in a national sample of U.S. middle-aged and older adults. Methods Data came from the 2018 interview of the Health and Retirement Study, a nationally representative cohort of approximately 20,000 U.S. older adults. Participants were asked if “a doctor had ever told them they have a sleep disorder,” and if so, which disorder, including sleep apnea. Participants reported frequency of insomnia symptoms (difficulty falling asleep, waking during the night, waking too early, and feeling rested in the morning), and were categorized as having each symptom if they reported experiencing the symptom “most of the time” for the first three symptoms and “rarely or never” for the latter. Employing bi-variate logistic regression, we compared demographic and clinical characteristics of participants with sleep apnea who reported ≥1 insomnia symptom (COMISA) to those reporting 0 symptoms (sleep apnea alone). Results Among N=1,816 respondents reporting sleep apnea, 47.2% also had insomnia symptoms (COMISA). Compared to those with sleep apnea alone, participants with COMISA were younger (65.3±9.61 years vs. 66.4±9.25, p=0.015), and more likely to be female (51.5% vs. 40.3%, p 0.001), but did not differ by race and ethnicity. They also were more likely to report several health conditions, including a markedly higher prevalence of mental health problems (43.1% vs. 24.8%, p 0.001), dementia/cognitive impairment (4.9% vs. 2.7%, p 0.001), and also have greater depressive symptomatology as measured by CES-D (2.8±2.44 vs. 1.1±1.67, p 0.001). Conclusion Notable differences were identified between participants with COMISA and those with OSA alone. Of note, COMISA patients were more likely to have several health conditions, especially mental health, which suggests COMISA patients may benefit from psychosocial interventions aimed at improving treatment adherence and preventing poor health outcomes. Support (if any) This study was supported by the National Institute on Aging (R01AG079391, K01AG061239, P30AG028740) and the Sleep Research Society Foundation (23-FRA-001).
Tseng et al. (Sat,) studied this question.