The relationship between obstructive sleep apnea and insomnia: a population-based cross-sectional polysomnographic...

Area of Science:

• Sleep Medicine
• Public Health Research

Background:

• Investigating the relationship between obstructive sleep apnea (OSA) severity and insomnia in the general population across both genders is novel.
• Previous research has not utilized population-based polysomnography (PSG) to examine this association.

Purpose of the Study:

• To evaluate the cross-sectional association between obstructive sleep apnea (OSA) severity and DSM-V insomnia and insomnia severity.
• To analyze the relationship between objectively measured OSA severity and insomnia symptoms in a general population sample.

Main Methods:

• A random sample of 1200 participants from the Nord-Trøndelag Health Study (HUNT3) underwent ambulatory polysomnography (PSG).
• Participants completed interviews and questionnaires to assess DSM-V insomnia diagnosis and Insomnia Symptom Score (ISS).
• Participants were categorized into groups based on apnea-hypopnea index (AHI): no OSA (AHI < 5), mild OSA (AHI 5-14.9), and moderate-to-severe OSA (AHI ≥ 15).

Main Results:

• Insomnia prevalence was 25.2% (29.1% women, 12.5% men) and did not differ significantly between those with and without OSA.
• Insomnia Symptom Score (ISS) significantly differed across OSA categories (p=0.001).
• Individuals with moderate-to-severe OSA reported lower ISS compared to those without OSA (mean difference -2.68, p=0.002), with a negative correlation between ISS and age in this group (r=-0.66, p=0.015).

Conclusions:

• No overall statistical association was found between obstructive sleep apnea (OSA) prevalence and insomnia in this population-based PSG study.
• Contrary to expectations, participants with moderate-to-severe OSA reported fewer insomnia symptoms than those without OSA.
• This inverse relationship between OSA severity and insomnia symptoms was particularly notable in older individuals.