Treating any underlying insomnia will markedly improve success rates in individuals recommended CPAP for sleep apnoea
Treating any underlying insomnia will markedly improve success rates in individuals recommended CPAP for sleep apnoea, new research suggests.
Patients with comorbid insomnia and sleep apnoea are more likely to persist with CPAP if they first undergo cognitive and behavioural therapy to treat their insomnia, researchers say.
In a study involving almost 150 patients with both insomnia and sleep apnoea, researchers found that firstly treating insomnia with psychological interventions, before starting CPAP, insomnia and its severity improved by 50% after six months.
Historically, patients who also have insomnia show poorer results from using continuous positive airway pressure, compared with patients who just have sleep apnoea, the study authors wrote in Oxford SLEEP.
In the study’ participants were randomised to receive either four sessions of cognitive behavioural therapy, or treatment as usual, before starting CPAP therapy for six months.
Those patients who received cognitive behavioural therapy not only had improved sleep but also used the CPAP for an additional 61 minutes per night on average.
Following the findings, the authors suggested patients with both conditions underwent a four to 10-week program of cognitive and behavioural therapy for insomnia, before starting to use a CPAP machine to reduce the effects of sleep apnoea.
Professor Doug McEvoy, co-author from the Adelaide Institute for Sleep Health at Flinders University said there were long-term cardio-metabolic risks for patients with comorbid insomnia and sleep apnoea, which could be considered, and relieved with the right treatment.
“This latest study suggests that sleep physicians and clinics should screen for insomnia symptoms and, if present, treat the insomnia with cognitive and behavioural therapy to improve subsequent acceptance and use of CPAP therapy. This will improve outcomes for both disorders,” he said.
Insomnia affects roughly one-third of all sleep apnoea patients who may report long-term difficulty falling asleep or long periods of being awake at night.
“Our study shows that cognitive and behavioural therapy is effective in improving insomnia severity and dysfunctional cognitions in the presence of an untreated obstructive sleep apnoea and will increase subsequent CPAP outcomes in this prevalent comorbid population,” the study authors concluded.
