Prevalence and incidence study of the association between insomnia and obstructive sleep apnea (COMISA) in a population sample

Abstract

Introduction: Obstructive sleep apnea (OSA) and insomnia are 2 of the most prevalent sleep disorders, negatively affecting physical and mental health. Both insomnia and OSA have great clinical and social relevance. More recently, emphasis has been given to the discussion about the simultaneous presence of both diseases, called COMISA - comorbid insomnia and sleep apnea. So far, little is known about COMISA and there is debate as to whether it would be a separate clinical entity, leading to a distinct profile of the disease, or whether it would be the association between these 2 diseases that promotes more serious health consequences. In this sense, the study of prevalence and incidence is essential to establish the first advances with regard to the unfolding of this phenomenon, given the importance it represents in the area of health. Objective: To investigate the prevalence and incidence of COMISA based on the Epidemiological Study of Sleep in the city of São Paulo - EPISONO. Methods: 3 editions of EPISONO will be used as the basis of this project: the 3rd edition (2007), the follow-up study of the 3rd edition (2015) and the 4th edition (2018). EPISONO is a population survey that used a representative sample and evaluated the main sleep disorders in the population of São Paulo, in addition to monitoring and describing the trends in the evolution of these disorders over time. For the analysis, correlation tests (Pearson or Spearman) and association (chi-square) will be used to correlate the symptoms of insomnia and OSA. The prevalence and incidence of COMISA will be determined and the relative risk (RR) will be calculated to estimate the magnitude of the association between the previous diagnosis of OSA or insomnia and the diagnosis of COMISA. With this project, it is expected to obtain a survey on the prevalence and incidence of COMISA and, based on this information, to contribute to the development of a clinical characterization of COMISA.