Association of obstructive airway disease with COMISA: findings from the Turkish sleep apnea database (TURKAPNE) cohort

Abstract

Comorbid insomnia and sleep apnea (COMISA) is a highly burdensome phenotype with additive effects on symptoms, quality of life, and health outcomes. Although obstructive airway diseases (OAD)—including asthma and chronic obstructive pulmonary disease—commonly coexist with sleep complaints, the association between OAD and COMISA in large sleep-clinic cohorts remains unclear. We investigated whether OAD is independently associated with COMISA in a nationwide cohort undergoing full-night polysomnography (PSG). Methods We analyzed 12,715 adults in the Turkish Sleep Apnea Database (TURKAPNE), a prospective, multicenter registry. Demographics, comorbidities, insomnia symptoms, and PSG parameters were compared between individuals with and without OAD, defined as self-reported, physician-diagnosed asthma or COPD. COMISA was defined as the coexistence of obstructive sleep apnea (apnea–hypopnea index ≥ 5 events/h) and insomnia symptoms occurring “often” or “very often.” Multivariable logistic regression was used to determine the independent association between OAD and COMISA. Results OAD was present in 12.2% of participants ( n = 1,546). COMISA prevalence was higher in those with OAD than in those without OAD (16.1% vs 10.8%, p