A total of 206 participants were analyzed, including 77 patients with chronic insomnia and obstructive sleep apnea ().
COMISA patients exhibited EEG power characteristics similar to both chronic insomniacs and obstructive sleep apnea patients.
In non-REM sleep stages, COMISA patients showed decreased delta and increased alpha and beta power.
During rapid eye movement (REM) sleep and multiple sleep latency tests, COMISA patients demonstrated increased beta power and also increased delta power.
Subjectively measured attention and negative beliefs about uncontrollability and danger of worry were worse in COMISA patients compared to obstructive sleep apnea patients.
Negative beliefs were positively associated with insomnia severity index scores.
Simplified
BACKGROUND: Chronic insomnia and obstructive sleep apnea commonly co-occur. Few studies have explored the neurophysiological and neurocognitive characteristics of , which could help guide improving treatment diagnostic tools and determining novel therapeutic targets. This study aims to explore the neurophysiological and neurocognitive characteristics of COMISA using electroencephalographic (EEG) spectral analysis and subjective and objective neurocognitive measurements.
METHODS: Participants were from our community recruited OSA-insomnia-COMISA cohort with 206 included for our current analysis including 74 chronic insomniacs (CIs), 55 OSA patients and 77 COMISA patients. Standard polysomnography (PSG) and multiple sleep latency tests (MSLTs) were recorded and used to obtain relative EEG spectral power in each sleep stage during PSG and each session during MSLTs. A series of subjective and objective neurocognitive tests were conducted to evaluate executive function, attention, retrospective and prospective memory and meta-cognition.
RESULTS: In PSG and MSLTs, COMISA patients showed combined EEG power characteristics of both CIs and OSA. Specifically, COMISA patients exhibited similar EEG spectral characteristics to CIs, with decreased delta and increased alpha and beta power in NREM sleep stages, and increased beta power in REM and MSLTs. Similar to the EEG spectral power profile of OSA, COMISA patients showed increased delta power in REM and MSLTs. Compared to OSA patients, COMISA patients exhibited worse subjectively measured attention and meta-cognition related to negative beliefs about uncontrollability and danger of worry (NEG), which were positively associated with ISI scores.
CONCLUSIONS: The EEG spectral power characteristics of COMISA patients in overnight PSG and daytime MSLT appear to be the manifestation of elements of both CIs and OSA. However, the neurocognitive features of COMISA patients in subjectively measured attention and NEG meta-cognition were primarily affected by chronic insomnia.
Key numbers
206
Participants
Total number of participants included in the study.
74
Chronic Insomniacs (CIs)
Number of chronic insomniacs included in the analysis.
55
Obstructive Sleep Apnea (OSA) Patients
Number of OSA patients included in the analysis.
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Declarations. Ethics approval and consent to participate: The study was conducted according to the World Medical Association Declaration of Helsinki in 1975, as revised in 1983, and was approved by the Research Ethics Board of West China Hospital of Sichuan University (NO.1481). All subjects provided their informed written consent. Consent for publication: Written informed consent for publication was obtained from all participants. Competing interests: The authors declare no competing interests.
