Symptoms of insomnia among OSA patients before and after 2years of PAP treatment

Abstract

To assess the changes of insomnia symptoms among patients with obstructive sleep apnea (OSA) from starting treatment with positive airway pressure (PAP) to a two-year follow-up. All subjects underwent a medical examination, type 3 sleep study and answered questionnaires on health and sleep before and 2 years after starting PAP treatment. The change in prevalence of insomnia symptoms by subtype were assessed by questionnaire and compared between individuals who were using or not using PAP at follow-up. Symptoms of middle insomnia were most common at baseline and improved significantly among subjects using PAP (from 59.4% to 30.7%, p < 0.001). Symptoms of initial insomnia tended to persist, regardless of PAP treatment and symptoms of late insomnia were more likely to improve among subjects not using PAP. Subjects with symptoms of initial and late insomnia at baseline were less likely to adhere with PAP (odds ratio (OR) 0.56, p = 0.007, and OR 0.53, p < 0.001, respectively). PAP treatment significantly reduced symptoms of middle insomnia. Symptoms of initial and late insomnia, however, tended to persist regardless of PAP treatment and had a negative effect on treatment adherence. Targeted treatment for insomnia may be beneficial for patients with OSA comorbid with insomnia and has the potential to positively affect adherence to PAP. Support: NIH grant HL72067 for “A Family Linkage Study of Obstructive Sleep Apnoea” and HL94307 for “Endophenotypes of Sleep Apnea and Role of Obesity”, the Eimskip Fund of the University of Iceland and the Landspitali University Hospital Research Fund.