Co-morbid Insomnia and Sleep Apnoea (COMISA): Latest Research from an Emerging Field

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Purpose of Review
Insomnia and sleep apnoea are the two most prevalent sleep disorders and frequently co-exist. Co-morbid insomnia and sleep apnoea (COMISA) is increasingly recognised as a highly prevalent condition that is associated with worse sleep, daytime function, physical and mental health compared to either disorder alone. Compared to people with sleep apnoea alone, those with COMISA are less likely to accept and use positive airway pressure therapy, the most efective treatment for sleep apnoea. Given the high prevalence, morbidity and complexities in efectively managing COMISA, it is critical to develop a better understanding of the aetiology, consequences and efective treatments for this  condition. This report aims to provide an overview of recent COMISA research.

Recent Findings

This report presents an overview of emerging areas of COMISA research over the past 5 years, including (1) mental and physical health associations of COMISA, (2) bi-directional relationships between insomnia and sleep apnoea, (3) positive airway pressure therapy for COMISA and (4) cognitive behavioural therapy for COMISA. Future research directions
are discussed, including tailored treatment approaches and implementation programs to improve recognition and management of COMISA.


COMISA is a highly prevalent and debilitating condition in sleep clinic and population-based settings. Emerging
research aims to develop and implement more efective and tailored treatment approaches for COMISA, to improve sleep,
mental health, physical health and quality of life in people with COMISA.
Original languageEnglish
Pages (from-to)180-189
Number of pages10
JournalCurrent Sleep Medicine Reports
Issue number3
Early online date26 Jul 2023
Publication statusPublished - Sept 2023


  • CBT-I
  • Cognitive behavioural therapy for insomnia
  • CPAP
  • Difficulties initiating and maintaining sleep
  • Positive airway pressure
  • Sleep-disordered breathing


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