Alexander Sweetman1, Leon Lack2, Sky Lambert3, Michael Gradisar4, Jodie Harris5. 1. Adelaide Institute for Sleep Health: Flinders Centre for Research Excellence, Flinders University of South Australia, Bedford Park, SA, 5042, Australia; School of Psychology, Flinders University of South Australia, Bedford Park, SA, 5042, Australia. Electronic address: alexander.sweetman@flinders.edu.au. 2. Adelaide Institute for Sleep Health: Flinders Centre for Research Excellence, Flinders University of South Australia, Bedford Park, SA, 5042, Australia; School of Psychology, Flinders University of South Australia, Bedford Park, SA, 5042, Australia. Electronic address: leon.lack@flinders.edu.au. 3. Adelaide Institute for Sleep Health: Flinders Centre for Research Excellence, Flinders University of South Australia, Bedford Park, SA, 5042, Australia. Electronic address: lamb0095@flinders.edu.au. 4. Adelaide Institute for Sleep Health: Flinders Centre for Research Excellence, Flinders University of South Australia, Bedford Park, SA, 5042, Australia. Electronic address: michael.gradisar@flinders.edu.au. 5. Centre for Treatment of Anxiety and Depression (CTAD), Central Adelaide Local Health Network (CALHN), SA Health, Adelaide, Australia. Electronic address: jodie.harris@sa.gov.au.
Abstract
AIMS: Comorbid insomnia and obstructive sleep apnea (OSA) represents a highly prevalent and debilitating condition; however, physicians and researchers are still uncertain about the most effective treatment approach. Several research groups have suggested that these patients should initially receive treatment for their insomnia before the sleep apnea is targeted. The current study aims to determine whether Cognitive and Behavioral Therapy for Insomnia (CBT-i) can effectively treat insomnia in patients with comorbid OSA and whether its effectiveness is impaired by the presence of OSA. METHODS: A retrospective chart review was conducted to examine 455 insomnia patients entering a CBT-i treatment program in a hospital out-patient setting. Three hundred and fourteen patients were diagnosed with insomnia alone and 141 with insomnia and comorbid OSA. Improvements in average sleep diary parameters, global insomnia severity, and several daytime functioning questionnaires from baseline, to post-treatment, to 3-month follow-up were compared between insomnia patients with and without comorbid OSA. RESULTS: Insomnia patients with comorbid OSA experienced significant improvements in insomnia symptoms, global insomnia severity, and other daytime functioning measures during and following treatment. Furthermore, improvements were no different between patients with or without comorbid OSA. Sleep apnea presence and severity were not related to rates of insomnia-remission or treatment-resistance following treatment. CONCLUSIONS: CBT-i is an effective treatment in the presence of comorbid OSA. This information offers support for the suggestion that patients with comorbid insomnia and OSA should be treated with CBT-i prior to the treatment of the OSA.
AIMS: Comorbid insomnia and obstructive sleep apnea (OSA) represents a highly prevalent and debilitating condition; however, physicians and researchers are still uncertain about the most effective treatment approach. Several research groups have suggested that these patients should initially receive treatment for their insomnia before the sleep apnea is targeted. The current study aims to determine whether Cognitive and Behavioral Therapy for Insomnia (CBT-i) can effectively treat insomnia in patients with comorbid OSA and whether its effectiveness is impaired by the presence of OSA. METHODS: A retrospective chart review was conducted to examine 455 insomniapatients entering a CBT-i treatment program in a hospital out-patient setting. Three hundred and fourteen patients were diagnosed with insomnia alone and 141 with insomnia and comorbid OSA. Improvements in average sleep diary parameters, global insomnia severity, and several daytime functioning questionnaires from baseline, to post-treatment, to 3-month follow-up were compared between insomniapatients with and without comorbid OSA. RESULTS:Insomniapatients with comorbid OSA experienced significant improvements in insomnia symptoms, global insomnia severity, and other daytime functioning measures during and following treatment. Furthermore, improvements were no different between patients with or without comorbid OSA. Sleep apnea presence and severity were not related to rates of insomnia-remission or treatment-resistance following treatment. CONCLUSIONS:CBT-i is an effective treatment in the presence of comorbid OSA. This information offers support for the suggestion that patients with comorbid insomnia and OSA should be treated with CBT-i prior to the treatment of the OSA.
Authors: Bastien Lechat; Kelly A Loffler; Douglas M Wallace; Amy Reynolds; Sarah L Appleton; Hannah Scott; Andrew Vakulin; Nicole Lovato; Robert Adams; Danny J Eckert; Peter G Catcheside; Alexander Sweetman Journal: Nat Sci Sleep Date: 2022-10-13
Authors: Nancy S Redeker; Henry Klar Yaggi; Daniel Jacoby; Christopher S Hollenbeak; Stephen Breazeale; Samantha Conley; Youri Hwang; Joanne Iennaco; Sarah Linsky; Uzoji Nwanaji-Enwerem; Meghan O'Connell; Sangchoon Jeon Journal: Sleep Date: 2022-01-11 Impact factor: 6.313
Authors: Jason C Ong; Megan R Crawford; Spencer C Dawson; Louis F Fogg; Arlener D Turner; James K Wyatt; Maria I Crisostomo; Bantu S Chhangani; Clete A Kushida; Jack D Edinger; Sabra M Abbott; Roneil G Malkani; Hrayr P Attarian; Phyllis C Zee Journal: Sleep Date: 2020-09-14 Impact factor: 5.849
Authors: Alexander Sweetman; Bastien Lechat; Peter G Catcheside; Simon Smith; Nick A Antic; Amanda O'Grady; Nicola Dunn; R Doug McEvoy; Leon Lack Journal: Front Psychol Date: 2021-05-04
Authors: Alexander Sweetman; Leon Lack; R Doug McEvoy; Peter G Catcheside; Nick A Antic; Ching Li Chai-Coetzer; James Douglas; Amanda O'Grady; Nicola Dunn; Jan Robinson; Denzil Paul; Simon Smith Journal: J Clin Sleep Med Date: 2021-03-01 Impact factor: 4.062