Sleep structure in patients with COMISA compared to OSA and insomnia
- S-Med
- Jul 18
- 2 min read
he aim of this study was to investigate differences in sleep structure measured with PSG between patients with OSA, COMISA, or insomnia. The main finding was that the duration and frequency of long awakenings is different between the 3 groups. We found that patients with COMISA or insomnia have a longer WASO compared to patients with OSA. Although we expected to find a higher number of awakenings in patients with OSA or COMISA due to brief post obstruction awakenings, the frequency of awakenings did not differ between the groups. This leads to a longer mean duration of an awakening for patients with COMISA or insomnia vs OSA.
By separating awakenings based on their duration, we established that the COMISA and insomnia groups exhibited more long awakenings compared to the OSA group. Although the absolute number of long awakenings does not seem to differ much between the groups, the parameter WASO≥5 min demonstrates the extent of prolonged wakefulness in patients with COMISA or insomnia. This suggests that patients with COMISA are more often awake for a prolonged period, which seems to be distinctive in comparison to patients with OSA. However, only the mean duration of awakenings and WASO≥5 min showed moderate effect sizes, indicating that these parameters alone are not perfectly discriminative between patients with OSA and those with COMISA. Nevertheless, they show a larger effect size compared to the standard wake parameters currently derived from PSG. We speculate that the COMISA group is heterogeneous. Differences on awakenings might be more attenuated for specific phenotypes and less for others, blurring the discriminant power of these PSG markers. A similar trend was found between the COMISA and OSA groups in the AHI-matched sample and highlighted by the statistically significant difference for the variable WASO≥5 min. However, in this matched subgroup WASO and the number of long awakenings were not statistically significant different. This could be a consequence of the lower sample size of the OSA group in the AHI-matched sample, influencing statistical power.
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