Dados do Trabalho

Título

Prevalence and profile of insomnia comorbid with obstructive sleep apnea in the sleep outpatient clinic of a University Hospital

Introdução

Insomnia and obstructive sleep apnea (OSA) are the most prevalent sleep disorders. Although the insomnia comorbid with obstructive sleep apnea (COMISA) described more than 40 years ago, it is still a subject of investigation.

Objetivo

To estimate the prevalence of COMISA in the sleep outpatient clinic of a university hospital and to study the profile of individuals with this disorder comparing them to those with only OSA and insomnia.

Métodos

The study has a cross-sectional design, with prospective allocation and convenience sample. OSA, insomnia and COMISA were defined based on the “International Classification of Sleep Disorders”, 3rd edition, of the American Academy of Sleep Medicine. Type I polysomnography (PSG) was performed on all individuals. Participants were stratified into 2 groups: 1- WITHOUT COMISA (only OSA and only insomnia); 2- COMISA (insomnia comorbid with OSA). Frequencies were estimated in both groups. The significance level considered was 5%.

Resultados

The sample consisted of 69 individuals. The prevalence of COMISA was 55.07%. The criteria for insomnia were met in 42 individuals but only 13% had insomnia alone. The prevalence of OSA alone was 83.87%. Females were more frequent in the COMISA group (63%) and males in the WITHTOUT COMISA (58%). The median age was higher in COMISA. Among chronic diseases, with the exception of chronic obstructive pulmonary disease and hypothyroidism, all were more frequent in COMISA, especially cardiovascular diseases and type 2 diabetes mellitus. Depression and anxiety in this group was also higher, with a statistical association (0.016 and 0.008, respectively). A higher number of mild OSA was observed in the COMISA, although moderate and severe degrees were also more frequent in this group. Only 8 individuals with cognitive impairment were found, 4 in each group, however, moderate and severe degrees were more frequent in the COMISA group. In the analysis of monthly family income, the lowest median occurred in the COMISA group, approximately 1.6 times lower than in the WITHOUT COMISA. The median level of education was the same for both groups.

Conclusões

A higher prevalence of COMISA was observed in the sample and an association with anxiety and depression. This group also had a higher frequency of chronic diseases and lower monthly family income. This demonstrates the need for identification and understanding different phenotypes in this disorder which may require different management.

Palavras -chave

COMISA, obstructive sleep apnea, insomnia, prevalence