title: Prevalence of insomnia symptoms in patients with sleep-disordered breathing.
abstract: OBJECTIVE
  To assess the prevalence of insomnia symptoms in patients with objectively diagnosed sleep-disordered breathing (SDB).
  
  
  METHODS
  Retrospective medical chart review of a representative sample of patients with SDB.
  
  
  METHODS
  University sleep-disorders clinic and laboratory.
  
  
  METHODS
  Two hundred thirty-one patients with SDB were selected from a pool of approximately 2,000 patients with sleep disorders.
  
  
  METHODS
  Data were extracted from intake questionnaires and polysomnographic studies.
  
  
  RESULTS
  Of 231 patients with SDB diagnoses, 115 patients reported no insomnia complaints (SDB-only patients) and 116 patients reported clinically meaningful insomnia complaints (SDB-plus patients). Compared to SDB-only patients, SDB-plus patients reported significantly worse mean sleep characteristics consistent with insomnia, including sleep latency (17 min vs 65 min), total sleep time (7.2 h vs 5.6 h), and sleep efficiency (92% vs 75%). SDB-plus patients experienced significantly more psychiatric disorders, cognitive-emotional symptoms, and physical and mental symptoms that disrupted or prevented sleep. SDB-plus patients also reported greater use of sedative and psychotropic medications and had significantly more primary complaints of insomnia, restless legs or leg jerks, and poor sleep quality despite having relatively similar referral rates for sleep apnea or complaints of loud snoring.
  
  
  CONCLUSIONS
  Problematic insomnia symptoms were reported by 50% of a representative sample of patients with objectively diagnosed SDB. Research is needed to determine the degree to which insomnia and related symptoms and behaviors interfere with SDB treatment.
authors.affiliation: Sleep and Human Health Institute, Albuquerque, NM 87110, USA. bkrakow@salud.unm.edu
authors.forename: B
authors.initials: B
authors.lastname: Krakow
authors.forename: D
authors.initials: D
authors.lastname: Melendrez
authors.forename: E
authors.initials: E
authors.lastname: Ferreira
authors.forename: J
authors.initials: J
authors.lastname: Clark
authors.forename: T D
authors.initials: TD
authors.lastname: Warner
authors.forename: B
authors.initials: B
authors.lastname: Sisley
authors.forename: D
authors.initials: D
authors.lastname: Sklar
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology*