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Co-morbid insomnia and sleep apnea and cardiovascular consequences: is the whole greater than each part?
Co-morbid insomnia and sleep apnea and cardiovascular consequences: is the whole greater than each part?
Soraya Giatti 1, 2, Henrique Cotchi Muela 2, Naira Lapi Ferreira 1, 3, Barbara K. Parise 1, 2, Luciano F. Drager 1, 2, 3
1 Centro de Pesquisa Clínica e Epidemiológica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; 2 Unidade de Hipertensão, Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; 3 Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas. Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
*Correspondence: Luciano F. Drager. Email: luciano.drager@incor.usp.br
Abstract
Recently, the sleep field has adopted the term co-morbid insomnia and sleep apnea (COMISA) to describe patients who present these two important sleep disorders. There is no novelty in the fact that a considerable number of patients may present not only one sleep disturbance but also a combination of them. In this scenario, it is reasonable to speculate that co-morbid sleep disturbances (e.g., COMISA) may have myriad consequences beyond each condition. While intuitive, this argument may sound simplistic because the impact of each sleep disturbance may not have the same “weight” across domains, making it fair to argue that one sleep disturbance may mitigate the effects of the other, thereby not imposing any “additional” effect. Fortunately, the traditional view in the literature of studying one sleep disturbance at a time has recently changed. In this review, we will summarize the current evidence on the cardiovascular effects of COMISA compared with each condition alone.
