Comorbid insomnia and obstructive sleep apnea in military personnel: Correlation with polysomnographic variables
Abstract
OBJECTIVES: Military personnel undergoing polysomnography are typically diagnosed only with obstructive sleep apnea (OSA). Comorbid insomnia with OSA is a well-established, underappreciated diagnosis. We sought to determine if military personnel with mild OSA met clinical criteria for insomnia and if there was a pattern of polysomnogram (PSG) variables that identified insomnia in these patients. METHODS: Retrospective chart review of military personnel with mild OSA; cluster analysis to describe PSG variables. RESULTS: 206 personnel assessed, predominately male (96.6%), mean age 36.5 ± 8.14 years, body mass index 30.2 ± 3.66 kg/m(2) and apnea hypopnea index of 8.44 ± 2.92 per hour; 167 (81.1%) met criteria for insomnia. Cluster analysis identified a group of patients (N = 52) with PSG variables of increased wakefulness after sleep onset 77.3 minutes (27.7) (p < 0.001) and decreased sleep efficiency 82.6% (5.82) (p < 0.001) consistent with insomnia. Patients in this group were more likely to meet criteria for insomnia with an odds ratio 5.27 (1.20, 23.1), (p = 0.009). CONCLUSIONS: The majority of military personnel with mild OSA meet criteria for insomnia. Roughly one-third of these patients can be identified by a pattern of PSG variables. Recognizing and treating both comorbid insomnia and OSA could improve clinical outcomes.
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The Zhang meta-analysis excluded studies investigating veterans and samples comprised of trauma patients, in which even higher COMISA prevalence rates have been reported.
“Interestingly, this meta-analysis excluded studies investigating veterans and samples comprised of trauma patients, in which even higher COMISA prevalence rates have been reported [44,45].”
From Co-morbid insomnia and sleep apnea (COMISA): Prevalence, consequences, methodological considerations, and recent randomized controlled trials (2019) · cites this paper as [45]
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- Authors
- Mysliwiec, V., Matsangas, P., Baxter, T., McGraw, L., Bothwell, N. E., & Roth, B. J.
- Affiliations
- Madigan Army Medical Center (US)
- Naval Postgraduate School (US)
- Venue
- Military Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-03
- Volume
- 179
- Issue
- 3
- Pages
- 294-300
- ISSN
- 0026-4075 (ISSN-L)
- 1930-613X
- OpenAlex
- W2062612521
- Cited by
- 30
- References
- 40
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 9 · 2019: 5 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 1
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Military Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Center for Neuroscience and Regenerative Medicine
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- obstructive sleep apnea, insomnia, comorbidities, military personnel, polysomnography, wake after sleep onset, sleep efficiency, mild sleep apnea, sleep-disordered breathing
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Male, Military Personnel, Retrospective Studies, Sleep Apnea Syndromes, United States, Comorbidity, Polysomnography
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