Abstract

ABSTRACT Obstructive sleep apnea (OSA) is a heterogeneous disorder characterized by recurrent upper airway collapse during sleep. Its clinical presentation is variable and frequently coexists with other sleep disorders, particularly insomnia. The co-occurrence of OSA and insomnia, referred to as comorbid insomnia and sleep apnea (COMISA), has recognized clinical significance. Objective: To clinically characterize women with OSA evaluated at a tertiary care center, comparing those with comorbid insomnia (COMISA group) to those with OSA alone. Methods: Prospective observational study including women aged ≥ 18 years with a confirmed diagnosis of OSA (apnea-hypopnea index ≥ 5 events/ hour). Insomnia symptoms were assessed using the Insomnia Severity Index (ISI); scores ≥ 8 indicated clinically significant insomnia. Results: A total of 103 women with OSA (median age: 56 years) were included. Insomnia was identified in 86% of participants based on ISI scores. Moderate to severe OSA was present in 69%, and 82% were classified as obese. Compared with those without insomnia, the COMISA group exhibited more severe depressive symptoms and greater daytime sleepiness. Conclusion: Insomnia is highly prevalent among women with OSA and is associated with increased symptom burden. Our findings underscore the need for a comprehensive management approach that addresses both conditions to optimize clinical outcomes. Keywords: sleep apnea, obstructive; insomnia; depression; dyssomnias