Comorbid insomnia and sleep apnea in children: a preliminary explorative study

Area of Science:

• Pediatric Sleep Medicine
• Sleep Disorders Research
• Clinical Phenotyping

Background:

• Insomnia and sleep-disordered breathing (SDB) are common sleep disorders.
• The co-occurrence of these conditions, termed comorbid insomnia and sleep apnea (COMISA), is not well-defined in pediatric populations.
• Understanding COMISA is crucial for improving diagnostic accuracy and clinical outcomes in children.

Purpose of the Study:

• To determine the prevalence of COMISA in children and adolescents referred for SDB evaluation.
• To characterize the clinical phenotype associated with COMISA in this age group.
• To establish phenotypic constructs for better definition and diagnosis of COMISA in pediatrics.

Main Methods:

• Retrospective cross-sectional study of two cohorts (Cohort #1: 50 children, Cohort #2: 384 children) aged 9-19 years.
• Evaluation using validated questionnaires for SDB and insomnia symptoms.
• Cohort #2 data included polysomnographic findings.

Main Results:

• In Cohort #1, 18% had high risk of COMISA, 36% had insomnia alone, and 56% were at high risk of SDB.
• In Cohort #2, 16% had COMISA, 12% had insomnia alone, and 72% had SDB alone.
• COMISA was associated with increased sleepiness and fatigue in both waking and daytime hours.

Conclusions:

• COMISA is a frequent condition in the pediatric age range.
• The presence of COMISA is associated with a more pronounced symptomatic phenotype, including significant sleepiness and fatigue.
• Further research into COMISA can enhance diagnostic sensitivity and clinical care for pediatric sleep disorders.