Comorbid insomnia and sleep apnea as a potential predictor of suicide and self-harm. Commentary on Udholm et al. Obstructive sleep apnea and risk of suicide and self-harm: A Danish Nationwide Cohort Study.

Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders and frequently co-occur. Co-morbid insomnia and sleep apnea (COMISA) is a highly prevalent condition that is associated with worse morbidity compared to insomnia-alone or sleep apnea-alone. Indeed, up to 50% of people with OSA report co-occurring insomnia symptoms, including difficulties initiating sleep, maintaining sleep, and/or early morning awakenings from sleep, with associated daytime impairment. People with COMISA also have increased depression prevalence and severity, worse sleep, and reduced quality of life, compared to people with OSA alone. A study by Choi and colleagues previously found that among 117 sleep clinic patients with untreated OSA, insomnia symptoms were positively associated suicidal ideation after controlling for age and gender.