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CC BY-NC-ND 4.0 · Sleep Sci 2019; 12(03): 190-195
DOI: 10.5935/1984-0063.20190085
ORIGINAL ARTICLE

Men and women with chronic insomnia disorder and OSAS: Different responses to CPAP

Isabel Loução-de-Amorim
1   Hospital de Santa Maria - CHULN, Department Neurosciences and Mental Health, Neurology, EEG/Sleep Laboratory, - Lisbon - Lisbon - Portugal.
,
Carla Bentes
1   Hospital de Santa Maria - CHULN, Department Neurosciences and Mental Health, Neurology, EEG/Sleep Laboratory, - Lisbon - Lisbon - Portugal.
2   Faculty of Medicine, University of Lisbon - Lisbon - Lisbon - Portugal.
,
Ana Rita Peralta
1   Hospital de Santa Maria - CHULN, Department Neurosciences and Mental Health, Neurology, EEG/Sleep Laboratory, - Lisbon - Lisbon - Portugal.
2   Faculty of Medicine, University of Lisbon - Lisbon - Lisbon - Portugal.
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Objective To evaluate the response to CPAP in patients with chronic insomnia disorder (CID) with OSAS in an unselected patient population including all OSAS severity groups. As a secondary objective, we also wanted to evaluate the differences between patients that improve insomnia symptoms with CPAP and patients that do not improve, specifically evaluating possible gender differences.

Methods Retrospective study of patients with a diagnosis of OSAS treated with CPAP and CID at the first clinical visit, selected from a database of an outpatient sleep clinic of University Hospital.

Results From a database of total of 827 patient, 90 patients were identified with OSAS and CID (53.3% women). Middle / moderate OSAS was diagnosed in 68.9% and severe OSA in 31.1%. Most patients (61.1%) improved insomnia symptoms after CPAP therapy. In the responders group, 58.2% had initial insomnia, 63.6% middle insomnia and 12.7% late insomnia. Responders to CPAP were more frequently women (women 61.8%, men 38.2%, p = 0.035) and there was no other difference between responders and non-responders. On subgroup analysis, this difference was significant only in severe OSAS (women 88.9%, men 31.6%, p = 0.013).

Conclusion In most patients with CID and OSA, there is a consistent reduction of insomnia symptoms with the CPAP use. This factor emphasizes the importance of performing PSG in CID. Insomnia in men with severe OSAS responds less frequently to CPAP suggesting that in these cases the insomnia phenotype is less dependent on the respiratory symptoms.

Sleep Apnea, Obstructive - Continuous Positive Airway Pressure - Sleep Initiation and Maintenance Disorders


Publication History

Received: 10 March 2019

Accepted: 17 June 2019

Article published online:
31 October 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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