Table 1. Prevalence rates of comorbid sleep apnea and insomnia.
| Authors,Ref. Year | Sample Size | Criteria for Sleep Apnea | Criteria for Insomnia | Prevalence of Comorbid Insomnia | Prevalence of Comorbid Sleep Apnea | ||
|---|---|---|---|---|---|---|---|
| Billings et al,25 2013 | 191 | OSA (AHI ≥ 15) | DIS frequent or always | 24% | |||
| Bjornsdottir et al,26 2012 | 826a | Untreated OSA patients referred for CPAP | DIS, DMS nearly every day | DIS: 12.6% men and 27.3% women; DMS: 51.6% men and 62.4% women | |||
| Bjornsdottir et al,27 in press | 705 | OSA (AHI ≥ 15) | DIS, DMS or EMA ≥3 nights/wk | DIS = 15.5%, DMS = 59.3%, EMA = 27.7% | |||
| Caetano Mota et al,28 2012 | 80 | OSA (AHI ≥5) | Self-reported present and new onset (self-report questionnaires) | 30% present, 21.4% new onset | |||
| Chung,29 2005 | 157 | OSA meeting ICSD criteria and AHI ≥5 | Insomnia symptoms (DIS, EMA and DMS [difficulty returning back to sleep and multiple wakenings]) | 42% at least 1 symptom; DIS = 6%, DMS = 26% (multiple wakenings) and 12% (difficulty returning to sleep), and EMA = 19% | |||
| Chung,30 2003 | 119a | OSA (AHI ≥5) | Insomnia symptoms (DIS, EMA and DMS [difficulty returning back to sleep and multiple wakenings]) | DMS = 33% (multiple wakenings) and 16% (difficulty returning to sleep), EMA = 21%, and DIS = 9% | |||
| Cronlein et al,31 2012 | 93 | SAS (AHI ≥ 10) | Meet ICSD-2 criteria for psychophysiological insomnia | 23% | |||
| Gooneratne et al,32 2006 | 99a | SRBD (AHI ≥15) | Insomnia symptoms ≥3 nights/wk for ≥3 wk | 29.3% | |||
| Johansson et al,33 2009 | 183a | OSA (AHI ≥5) | Some or more problems with DIS, DMS, EMA reported | DIS = 44%, DMS = 63%, EMA = 37% | |||
| Kinugawa et al,34 2012 | 64 | SAS (AHI ≥ 15) | ICSD-2 criteria for insomnia | 68.7% | |||
| Krakow et al,35 2001 | 231 | SDB (UARS or OSA: clinical criteria and AHI ≥5) | Clinically apparent insomnia symptoms (2 or more insomnia symptoms) | 50% | |||
| Krell and Kapur,36 2005 | 228a | SDB (AHI ≥10) | At least DIS, DMS, or EMA often/almost | 54.9% (DIS = 33.4%, DMS = 38.8%, always EMA = 531.4%) | |||
| Lichstein et al,37 1999 | 80 | AHI >15 | ICSD criteria for insomnia | 29% (43% with AHI >5) | |||
| McCall et al,38 2009 | 73 | AHI ≥15 | SOL >30 min and SE <85% or RDC for >4 nights/wk | 7% | |||
| Ong et al,39 2009 | 51 | ICSD-2 criteria and AHI ≥15 | DSM-IV-TR criteria for insomnia | 39% | |||
| Smith et al,40 2004 | 105 | OSAHS (unclear) | Presenting with insomnia disorder | 39% | |||
| Stone et al,41 1994 | 45 | OSA (RDI >10) | TST <6 h, SOL/WASO >30 min for minimum 6 mo | 40% | |||
| Subramanian et al,42 2001 | 300 | OSA (AHI >10) | Insomnia (unclear), DIS, DMS, EMA, PPI | Insomnia 5 84%, DIS = 57%, DMS 5 68%, EMA = 48%, PPI = 49% | |||
| Vozoris,43 2012 | 546a | Self-reported health professional diagnosis of sleep apnea | DIS, DMS, EMA often or almost always | Any symptom 43.3% DIS = 25.9%, DMS = 28.8%, EMA = 20.8% | |||
Abbreviations: AHI, apnea-hypopnea index; CPAP, continuous positive airway pressure; DIS, difficulty initiating sleep; DMS, difficulty maintaining sleep; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revised; EMA, early morning awakenings; ICSD, International Classification of Sleep Disorders; OSA, obstructive sleep apnea; OSAHS, obstructive sleep apnea and hypopnea syndrome; PPI, psychophysiologic insomnia; RDC, research diagnostic criteria; RDI, respiratory disturbance index; SDB, sleep-disordered breathing; SOL, sleep-onset latency; TST, total sleep time; UARS, upper airway resistance syndrome; WASO, wake after sleep onset.
a
Sample size is not identical to the overall sample size recruited.