Individuals with both insomnia and sleep apnea are at greater risk of death due to any cause, suggests a study reported in the journal Sleep Epidemiology.¹

To explore the association between comorbid insomnia and sleep apnea and all-cause mortality, researchers examined 6877 participants from the National Health and Nutrition Examination Survey (NHANES) conducted from 2005 to 2008. The NHANES, conducted as a series of surveys, evaluates the nutritional and health status of adults and children in the United States. Half of the study population was male. The follow-up period was for 8.6 years (median). Obstructive sleep apnoea (OSA) was identified with the help of the STOP-Bang questionnaire. Nearly 74% of the participants had neither OSA nor insomnia, 3% had insomnia alone, 20% had OSA alone, while 3.3% had both insomnia and OSA. By 11 years, the mortality rate was 6.7%.

After adjusting for sociodemographic and behavioral factors, participants with comorbid insomnia and OSA were at a 2-folds higher risk of mortality compared to study subjects with no insomnia/OSA with hazard ratio of 1.9. Mortality was also higher among those who had insomnia alone compared to participants without insomnia or OSA with HR of 1.5.

The association between mortality and comorbid insomnia and OSA remained significant with HR of 1.6 even after further adjusting for duration of sleep, use of sleeping pills and chronic conditions. But the association between insomnia alone and mortality became nonsignificant with HR of 1.4.

This study shows that comorbid insomnia and OSA is a risk factor for mortality due to any cause. Hence, patients should be screened for comorbid insomnia and OSA using self-reported questionnaires as screening tools followed by institution of appropriate risk reduction strategies.

Reference

1. Alexander Sweetman, et al. Association of co-morbid insomnia and sleep apnoea symptoms with all-cause mortality: Analysis of the NHANES 2005-2008 data. Sleep Epidemiology. 2022;2:100043. https://doi.org/10.1016/j.sleepe.2022.100043.