P120 Incidence, persistence and remission of co-morbid insomnia and sleep apnea (COMISA) over time in the Wisconsin Sleep Cohort data

INTRODUCTION: Co-morbid insomnia and sleep apnea (COMISA) is a highly prevalent and debilitating condition that is more difficult to treat compared to either disorder alone. Previous studies have investigated the cross-sectional prevalence of COMISA, however no study has investigated rates of natural incidence, persistence, or remission of COMISA over time. METHODS: We used data from 566 people in the Wisconsin Sleep Cohort (Age M = 55.6 [sd = 7.5], 46.3% female). Symptoms of insomnia (difficulties initiating, maintaining sleep and/or early morning awakenings at least 5 times/month), and sleep apnea (AHI ≥ 5) were investigated at baseline, 4-years, and 8-years. COMISA was defined if both conditions were present. RESULTS: The prevalence of COMISA at baseline, year-4, and year-8 was 25.1%, 29.9%, and 25.8%, respectively. Among those with COMISA at baseline, 60.6% had persistent COMISA at year-4, and among people with COMISA at year-4, 46.8% had persistent COMISA at year-8. Very few people with COMISA experienced remission of both insomnia and sleep apnea at year-4 (5.6%) or year-8 (7.7%). There were 83 cases of incident COMISA at year-4 (19.6% of people without COMISA at baseline), and 67 cases of incident COMISA at year-8 (16.9% of people without COMISA at year-4). DISCUSSION: COMISA symptom prevalence was ≥25% at any given follow-up in this population-based sample. Approximately half of those with COMISA experienced persistent COMISA across any two follow-up occasions. Very few people with COMISA experience complete remission of both conditions. It is important to develop targeted treatments for this prevalent and persistent condition.