Positive Airway Pressure Therapy Compliance in Patients With Comorbid Insomnia and Sleep Apnea

Objectives. This study aimed to compare positive airway pressure (PAP) therapy compliance between patients with comorbid insomnia and sleep apnea (COMISA) and those with obstructive sleep apnea (OSA) alone. It also assessed the influence of insomnia clinic visits on PAP compliance. Methods. Patients diagnosed with OSA and initiated on PAP therapy between January 2012 and December 2021 were included. The COMISA group (n= 43) comprised patients with insomnia, while the control group (n= 86) consisted of OSA patients without insomnia, matched 1:2 based on age and sex. COMISA patients were further categorized into group A (n= 20), with at least two insomnia clinic visits, and group B (n= 23) with one or no visits. PAP compliance in each group was evaluated at 3 and 9 months. Results. No significant differences were observed in PAP compliance between the COMISA patients and OSA patients without insomnia. Within the COMISA group, the impact of insomnia clinic visits on PAP compliance was not significant. No significant difference was observed in daily PAP usage between the two groups at 3 months (265.5 +/- 145.9 minutes in group A vs. 236.3 +/- 152.3 minutes in group B, P= 0.760) or 9 months (213.4 +/- 155.3 minutes in group A vs. 166.3 +/- 158.3 minutes in group B, P=0.538). The percentages of PAP users and nights with PAP use exceeding 4 hours also showed no significant differences at either time point. Conclusion. This study demonstrated no significant disparity in PAP compliance between the COMISA and OSA groups at either 3 or 9 months. Furthermore, insomnia clinic visits did not significantly impact PAP compliance in COMISA patients during 3- and 9-month intervals.