Sleep disorders are complex to diagnose and treat. It’s hard even to get a good sense that you have a sleep disorder, since your doctor might not ask about it (and might not even know much about it). And once you think you might know you have a problem, it’s easy to misdiagnose the specific type of disorder.
This problem is highlighted by a new study showing that most people who seek treatment for insomnia actually have undiagnosed sleep apnea. But there’s an upside to this story. Sleep apnea treatment was able to help some of these people improve their sleep quality.
How Common Is Sleep Apnea in Insomnia Patients?
This study, published by The Lancet’s eClinicalMedicine, focuses on what it calls “complex insomnia,” in which patients have symptoms of both insomnia and obstructive sleep apnea. It started out with a population of over 660 patients seeking treatment for insomnia. However, 455 of those patients were dismissed from the study because it was so obvious that they had sleep apnea because of their overt signs and symptoms.
They settled on a study population of 40 insomnia patients who had no definitive symptoms of sleep apnea, but who had failed at behavioral or drug therapy for their insomnia for an average of ten years. However, when these patients were tested for sleep apnea, all 40 showed they had the condition.
In other words, of the initial 660 eligible patients, at least 75% had sleep apnea. And many of these patients have been undergoing insomnia treatment for at least ten years without either them or their doctor suspecting that they might have sleep apnea.
CPAP Failed as Treatment
Once researchers identified the 40 complex insomnia patients, they randomly assigned them to different treatment modes: 21 to continuous positive airway pressure (CPAP) and 19 to adaptive servo-ventillation (ASV–a kind of “smart” CPAP). The patients all went through three different rounds of fine-tuning their treatment, trying to find the best possible pressure, mask fit, etc. And they all got 14 weeks of coaching and follow-up to improve their compliance.
Despite all the tuning and coaching, though, CPAP only helped 24% of patients see improvement in their sleep quality. ASV did better, helping more than two-thirds of patients (68%).
Still, this means that many people who get this type of treatment fail to see the promised benefit. We need other treatment options to help people find an appropriate sleep apnea treatment that will really help them.
Having Trouble with Insomnia?
Are you having trouble with insomnia? Are the treatments you’re being given not helping? If so, it’s important to get tested for sleep apnea, which is likely to underlie your condition. Treating sleep apnea could help you finally get the deep, restful sleep you’ve been seeking.
And you should consider all your treatment options, including oral appliances, to make sure you find a treatment that will really help you.