Comorbid sleep disorders among patients presenting with insomnia who underwent polysomnography
- Author:
April Fatima Hernandez
;
Roland dela Eva
- Publication Type:Journal Article
- Keywords:
Comorbidity in Sleep Problems
- MeSH:
Sleep Initiation and Maintenance Disorders;
Sleep Wake Disorders;
Polysomnography;
Comorbidity
- From:
The Philippine Journal of Psychiatry
2023;4(2):54-
- CountryPhilippines
- Language:English
-
Abstract:
Objective:The aim of this study was to determine the comorbid sleep disorders on
Polysomnography (PSG) of patients complaining of insomnia symptoms.
Methodology:This is a retrospective study among patients who underwent diagnostic
and split-night polysomnography from April 2014 to February 2019. Those who had at
least one of the following insomnia symptoms of difficulty initiating sleep, difficulty
maintaining sleep and early morning awakening with or without a history of sleep aide use
were identified as patients with insomnia. Polysomnography sleep parameters and
outcome were tabulated and statistical analysis was done using SPSS v 20.0.
Results:Out of the 302 patients who were included in the study, 34.4% of subjects had a
family history of sleep disorder and 70.4% had a history of sleep aide use. Among the
medical comorbidities, 47.7% of the subjects were diagnosed with hypertension while
10.65% were diagnosed with psychiatric disorder. Most of the patients complained of
both difficulty initiating sleep and early morning awakening. PSG sleep parameters
showed that patients did not experience excessive daytime sleepiness or delayed sleep
latency. On the other hand, poor sleep efficiency could be due to increased arousal index.
Half of the patients turned out to have severe obstructive sleep apnea (52%) while 2.3% of
the patients had periodic limb movement disorder. Among those diagnosed with severe
OSA, 53.3% had a history of sleep aide use.
Conclusion:The study showed the importance of screening patients with insomnia for
underlying comorbid sleep disorders. The American Academy of Sleep Medicine (AASM)
treatment guidelines for chronic insomnia emphasized the need to have a high index of
suspicion for this population in order to recommend diagnostic procedures such as
polysomnography. Diagnosing a patient with insomnia to have an underlying sleep apnea
and/or periodic limb movement disorder would change the course of management among
patients with chronic insomnia and eventually avoid prescribing medications that could
actually worsen the patient’s condition.
- Full text:PJ Psychiatry 9.pdf
