TY - JOUR
T1 - Comorbid insomnia and obstructive sleep apnea in military personnel
T2 - Correlation with polysomnographic variables
AU - Mysliwiec, Vincent
AU - Matsangas, Panagiotis
AU - Baxter, Tristin
AU - McGraw, Leigh
AU - Bothwell, Nici E.
AU - Roth, Bernard J.
N1 - Publisher Copyright:
© Association of Military Surgeons of the U.S. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Objectives: Military personnel undergoing polysomnography are typically diagnosed only with obstructive sleep apnea (OSA). Comorbid insomnia with OSA is a well-established, underappreciated diagnosis. We sought to determine if military personnel with mild OSA met clinical criteria for insomnia and if there was a pattern of polysomnogram (PSG) variables that identified insomnia in these patients. Methods: Retrospective chart review of military personnel with mild OSA; cluster analysis to describe PSG variables. Results: 206 personnel assessed, predominately male (96.6%), mean age 36.5 ± 8.14 years, body mass index 30.2 ± 3.66 kg/m2 and apnea hypopnea index of 8.44 ± 2.92 per hour; 167 (81.1%) met criteria for insomnia. Cluster analysis identified a group of patients (N = 52) with PSG variables of increased wakefulness after sleep onset 77.3 minutes (27.7) (p < 0.001) and decreased sleep efficiency 82.6% (5.82) (p < 0.001) consistent with insomnia. Patients in this group were more likely to meet criteria for insomnia with an odds ratio 5.27 (1.20, 23.1), (p = 0.009). Conclusions: The majority of military personnel with mild OSA meet criteria for insomnia. Roughly one-third of these patients can be identified by a pattern of PSG variables. Recognizing and treating both comorbid insomnia and OSA could improve clinical outcomes.
AB - Objectives: Military personnel undergoing polysomnography are typically diagnosed only with obstructive sleep apnea (OSA). Comorbid insomnia with OSA is a well-established, underappreciated diagnosis. We sought to determine if military personnel with mild OSA met clinical criteria for insomnia and if there was a pattern of polysomnogram (PSG) variables that identified insomnia in these patients. Methods: Retrospective chart review of military personnel with mild OSA; cluster analysis to describe PSG variables. Results: 206 personnel assessed, predominately male (96.6%), mean age 36.5 ± 8.14 years, body mass index 30.2 ± 3.66 kg/m2 and apnea hypopnea index of 8.44 ± 2.92 per hour; 167 (81.1%) met criteria for insomnia. Cluster analysis identified a group of patients (N = 52) with PSG variables of increased wakefulness after sleep onset 77.3 minutes (27.7) (p < 0.001) and decreased sleep efficiency 82.6% (5.82) (p < 0.001) consistent with insomnia. Patients in this group were more likely to meet criteria for insomnia with an odds ratio 5.27 (1.20, 23.1), (p = 0.009). Conclusions: The majority of military personnel with mild OSA meet criteria for insomnia. Roughly one-third of these patients can be identified by a pattern of PSG variables. Recognizing and treating both comorbid insomnia and OSA could improve clinical outcomes.
UR - http://www.scopus.com/inward/record.url?scp=84924699921&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924699921&partnerID=8YFLogxK
U2 - 10.7205/MILMED-D-13-00396
DO - 10.7205/MILMED-D-13-00396
M3 - Article
C2 - 24594464
AN - SCOPUS:84924699921
SN - 0026-4075
VL - 179
SP - 294
EP - 300
JO - Military medicine
JF - Military medicine
IS - 3
ER -