Source:Sleep Medicine
Author(s): Alexander Sweetman, Leon Lack, Sky Lambert, Michael Gradisar, Jodie Harris
AimsCo-morbid insomnia and obstructive sleep apnea (OSA) represents a highly prevalent and debilitating condition, however physicians and researchers are still uncertain as to the most effective treatment approach. Several research groups have suggested that these patients should initially receive treatment for their insomnia before the sleep apnea is targeted. The current study aims to determine whether cognitive and behavioral therapy for insomnia (CBT-i) can effectively treat insomnia in patients with co-morbid OSA, and whether its effectiveness is impaired by the presence of OSA.MethodsA retrospective chart review was conducted to examine 455 insomnia patients entering a CBT-i treatment program in a hospital outpatient setting. 314 patients were diagnosed with insomnia-alone, and 141 with insomnia and co-morbid obstructive sleep apnea. Improvements in average sleep diary parameters, global insomnia severity, and several daytime functioning questionnaires from baseline, to post-treatment, to 3-month follow-up were compared between insomnia patients with- and without co-morbid sleep apnea.ResultsInsomnia patients with co-morbid OSA experienced significant improvements in insomnia symptoms, global insomnia severity, and other daytime functioning measures during and following treatment. Furthermore, improvements were no different between patients with or without co-morbid OSA. Sleep apnea presence and severity were not related to rates of insomnia-remission or treatment-resistance following treatment.ConclusionsCBT-i is an effective treatment in the presence of co-morbid OSA. This information offers support for the suggestion that patients with co-morbid insomnia and obstructive sleep apnea should be treated with CBT-i prior to treatment of the OSA.
from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2fogMe0
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