Insomnia Phenotype Characterization and Depression among Patients with Obstructive Sleep Apnea

Khosro  Sadeghniiat-Haghighi; Arezu  Najafi; Ania  Rahimi-Golkhandan; Nazanin  Forouzan; Samaneh  Akbarpour; Mashiyat  Mohammadzadeh

doi:10.18502/jss.v8i1-2.17871

Khosro Sadeghniiat-Haghighi Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Arezu Najafi Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ania Rahimi-Golkhandan Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Nazanin Forouzan Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Samaneh Akbarpour Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mashiyat Mohammadzadeh Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jss.v8i1-2.17871

Keywords: Obstructive sleep apnea; Insomnia; Depression; Sleep; Polysomnography

Abstract

Background and Objective: Over 40% of individuals with obstructive sleep apnea (OSA) have reported experiencing insomnia. The combination of OSA and insomnia results in decreased sleep quality and adherence to continuous positive airway pressure (CPAP) therapy. This study aimed to assess insomnia among patients with OSA.

Materials and Methods: This cross-sectional study involved 1771 participants. Patients with a high suspicion of OSA completed the Insomnia Severity Index (ISI) and the Beck Depression Inventory (BDI-II) questionnaires. All participants underwent overnight polysomnography (PSG).

Results: In this study, 1242 (68%) of the 1771 participants were men, with a mean age of 47.18 ± 13.65 years. The average Respiratory Disturbance Index (RDI) was 41.53 ± 31.98, the mean ISI score was 12.11 ± 5.99, and the ave r- age BDI score was 12.88 ± 11.22. A total of 639 (36%) participants reported moderate to severe insomnia (ISI score ≥ 15). Those with a normal RDI had mean ISI scores of 13.71 ± 6.32, while patients with mild, moderate, and severe OSA had mean ISI scores of 12.76 ± 5.96, 11.61 ± 5.92, and 11.91 ± 5.95, respectively (P = 0.001). The correlation between RDI and ISI score was 0.006 (P = 0.8). As the severity of insomnia increased, the BDI score also signifi- cantly increased (P < 0.0001).

Conclusion: A notable correlation exists between insomnia and depression; individuals with more severe insomnia re- ported higher depressive symptoms. Given the link between insomnia and OSA, it is advisable to assess insomnia in patients diagnosed with OSA.