Journal of International Psychiatry

Objective: To summarize the sleep characteristic structure of patients with comorbidity of insomnia and OSA by analyzing the subjective sleep perception and objective sleep structure of patients with insomnia, obstructive sleep apnea (OSA) and comorbidity of both.Methods: 517 patients were collected and divided into three groups including 184 insomniacs as insomnia group, 160 OSA patients as OSA group and 173 patients with comorbidity of insomnia and OSA as comorbidity group. All the patients underwent standard polysomnography(PSG) examination and scales to assess objective and subjective sleep situation of them. and then compare the differences in sleep strcture among the three groups and summrize the sleep characteristics of comorbidity group.Results:The scale of ISI and ESS showed that the subjective feelings of insomnia and daytime sleepiness in the combidity group were higher than those in  insomnia group or OSA group (P<0.01).Compared with the other two groups, comorbidity group had a lower total sleep time、a higher awakening index、lower percentage of N3 stage sleep and the blood oxygen (P<0.01) .Compared with OSA group, AHI, RDI and the longest time of AHI in comorbidity group increased (P<0.01).Conclusion: comorbidity of insomnia and OSA may be a specific subtype of OSA, and the main sleep structure is characterized by increased arousal index, further decreased N3%, and decreased blood oxygen at night. The group with the combidity of insomnia and OSA suffers a higher risk than that of OSA or insomnia only, which requires further screening and timely intervention in clinical practice.

insomnia; obstructive sleep apnea; comorbidity; polysomnography; sleep structure