Positive airway pressure therapy compliance in patients with comorbid insomnia and sleep apnea (COMISA).

Abstract

This study aimed to compare positive airway pressure (PAP) therapy compliance between patients with comorbid insomnia and sleep apnea (COMISA) and those with obstructive sleep apnea (OSA) alone, while assessing the influence of insomnia clinic visits on PAP compliance. Patients diagnosed with OSA and initiated on PAP therapy between January 2012 and December 2021 were included. The COMISA group (n = 43) comprised patients with insomnia, while the control group (n = 86) consisted of OSA patients without insomnia, matched 1:2 based on age and sex. COMISA patients were further categorized into Group A (n = 20) with at least two insomnia clinic visits and Group B (n = 23) with minimal or no visits. PAP compliance was evaluated for each group at 3 and 9 months. No significant differences were observed in PAP compliance between COMISA patients and OSA patients without insomnia. Within the COMISA group, the impact of insomnia clinic visits on PAP compliance was not significant. No significant difference was observed in the daily PAP usage between the two groups at 3 months (265.5 ± 145.9 min in Group A vs. 236.3 ± 152.3 min in Group B, p = 0.760) or 9 months (213.4 ± 155.3 min in Group A vs. 166.3 ± 158.3 min in Group B, p = 0.538). Percentages of PAP users and nights with PAP use exceeding 4 hours also showed no significant differences at both intervals. This study demonstrated no significant disparity in PAP compliance between the COMISA and control groups at either 3 or 9 months. Furthermore, insomnia clinic visits did not significantly impact PAP compliance in COMISA patients during the 3- and 9-month intervals.