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Article Abstract

Introduction: COMISA is defined as a comorbid condition comprising insomnia and obstructive sleep apnea (OSA). This study aims to assess the prevalence of COMISA and its association with cardiovascular risk factors within three population-based cohorts from Benin (BeSAS, n = 1733), Switzerland (HypnoLaus, n = 1999), and India (BLESS, n = 958).

Methods: OSA was assessed by nocturnal recordings, while the presence of insomnia symptoms was assessed by questionnaires in the three cohorts. Adjusted logistic regression models were employed to assess the associations of COMISA with hypertension, diabetes and metabolic syndrome. These associations were also examined using different COMISA definitions based on insomnia subtypes (initiation difficulties and early morning awakenings/maintenance difficulties).

Results: The crude prevalence of COMISA was 11.4 % in HypnoLaus, 9.1 % in BLESS and 1.7 % in BeSAS. In HypnoLaus, COMISA showed a trend towards an association with hypertension (OR: 1.34, p = 0.09) and metabolic syndrome (OR: 1.37, p = 0.09), which was statistically significant when insomnia was defined by sleep initiation difficulties. In BLESS, COMISA was significantly associated with both hypertension (OR: 3.30, p < 0.001) and metabolic syndrome (OR: 1.1.71, p = 0.008). No significant associations were observed in BeSAS.

Conclusion: COMISA has a high prevalence worldwide and may be associated with hypertension and metabolic syndrome.

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http://dx.doi.org/10.1016/j.sleep.2025.106526DOI Listing

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