Is insomnia an independent predictor of obstructive sleep apnea?
Robert N Glidewell1, Emily K Roby, William C Orr
1Lynn Institute for Healthcare Research, Colorado Springs, CO 80907, USA. rglidewell@lhsi.net
Introduction:
Obstructive sleep apnea (OSA) is a disorder with high prevalence in primary care. However, little research exists on screening for OSA in primary care samples.
Methods:
One hundred family medicine patients completed standardized symptom and demographic questionnaires and a structured clinical interview for sleep disorders. Two-step logistic regression was performed to determine the independent predictive value of insomnia for clinical identification of OSA. Additional t tests were computed to examine age and sex patterns of insomnia.
Results:
A model including body mass index and daytime sleepiness predicted OSA status (χ(2) = 18.63; P < .001) and explained 27% of the variance in OSA clinical diagnosis. Addition of insomnia scores to the model significantly improved predictive utility (χ(2) = 25.79; P < .001) and explained 36% of the variance in OSA. Insomnia scores were higher for women compared with men (P = .033) and women with OSA compared with women without OSA (P = .007).
Conclusions:
Inquiry regarding insomnia may improve clinical identification of OSA when screening for OSA in primary care. This finding possibly is unique to the evaluation of OSA in a primary care versus sleep laboratory sample. The predictive utility of insomnia may be specific to women.
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