title: The more the merrier? Working towards multidisciplinary management of obstructive sleep apnea and comorbid insomnia.
abstract: OBJECTIVE
  The goal of this article was to provide an overview of the diagnostic considerations, clinical features, pathophysiology, and treatment approaches for patients with obstructive sleep apnea (OSA) and comorbid insomnia.
  
  
  METHODS
  We begin with a review of the literature on OSA and comorbid insomnia. We then present a multidisciplinary approach using pulmonary and behavioral sleep medicine treatments.
  
  
  RESULTS
  OSA and insomnia co-occur at a high rate and such patients have distinct clinical features. Empirically supported treatments are available for OSA and insomnia independently but there are no standards or guidelines for how to implement these treatments for patients who suffer from both disorders.
  
  
  CONCLUSIONS
  Multidisciplinary treatment holds promise for patients with comorbid sleep disorders. Further research should be aimed at optimizing treatments and developing standards of practice for this population.
authors: Rush University Medical Center.
authors: Jason C
authors: JC
authors: Ong
authors: M Isabel
authors: MI
authors: Crisostomo
mesh_terms: D000328:Adult; D001524:Behavioral Medicine / Q000379:methods; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods*; D015897:Comorbidity; D019468:Disease Management; D006801:Humans; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000628:therapy*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000628:therapy*; D056508:Sleep Medicine Specialty / Q000295:instrumentation / Q000379:methods
keywords: behavioral sleep medicine; comorbidity; insomnia; multidisciplinary approach; obstructive sleep apnea
references: BMJ. 2001 Jun 23;322(7301):1511-6
references: 11420271
references: Am J Respir Crit Care Med. 2005 Dec 1;172(11):1447-51
references: 16141444
references: Sleep Breath. 2010 Feb;14(1):63-70
references: 19629554
references: Best Pract Res Clin Endocrinol Metab. 2010 Oct;24(5):703-15
references: 21112020
references: Psychosom Med. 2001 Jul-Aug;63(4):579-84
references: 11485111
references: Chest. 2001 Dec;120(6):1923-9
references: 11742923
references: Am J Respir Crit Care Med. 1999 Apr;159(4 Pt 1):1108-14
references: 10194153
references: Am J Respir Crit Care Med. 2001 Jan;163(1):19-25
references: 11208620
references: Sleep. 1992 Dec;15(6 Suppl):S42-6
references: 1470808
references: Am J Respir Crit Care Med. 1999 Feb;159(2):495-501
references: 9927363
references: J Chronic Dis. 1985;38(5):427-34
references: 3998057
references: Respiration. 2005 Sep-Oct;72(5):460-5
references: 16210883
references: J Consult Clin Psychol. 1999 Jun;67(3):405-10
references: 10369061
references: Sleep Med Rev. 2002 Apr;6(2):97-111
references: 12531146
references: J Psychosom Res. 2011 Apr;70(4):355-61
references: 21414455
references: Sleep. 2003 May 1;26(3):308-11
references: 12749550
references: Arch Gen Psychiatry. 2011 Oct;68(10):992-1002
references: 21646568
references: Chest. 1986 Sep;90(3):330-3
references: 3527583
references: Sleep Med. 2004 Sep;5(5):449-56
references: 15341889
references: Am J Drug Alcohol Abuse. 2002;28(1):73-90
references: 11853136
references: N Engl J Med. 1993 Apr 29;328(17):1230-5
references: 8464434
references: JAMA. 2000 Apr 12;283(14):1829-36
references: 10770144
references: Sleep. 2011 Sep 01;34(9):1161-71
references: 21886353
references: Arch Intern Med. 2006 Sep 18;166(16):1732-8
references: 16983051
references: Chest. 2006 Nov;130(5):1369-76
references: 17099012
references: Sleep. 2006 Feb;29(2):240-3
references: 16494092
references: Chest. 2010 Jun;137(6):1449-63
references: 20525657
references: J Clin Sleep Med. 2010 Apr 15;6(2):196-204
references: 20411700
references: Sleep. 2008 Jun;31(6):881-6
references: 18548834
references: Thorax. 1994 Mar;49(3):263-6
references: 8202884
references: Percept Mot Skills. 1994 Jun;78(3 Pt 2):1116-8
references: 7936934
references: Sleep Breath. 2005 Sep;9(3):104-10
references: 16091954
references: J Gen Intern Med. 2007 Sep;22(9):1335-50
references: 17619935
references: Sleep. 2010 Apr;33(4):459-65
references: 20394314
references: Drug Alcohol Depend. 2007 May;88 Suppl 2:S24-30
references: 17056207
references: Am J Respir Crit Care Med. 2002 May 1;165(9):1217-39
references: 11991871
references: Sleep. 2006 Nov;29(11):1415-9
references: 17162987
references: Am J Respir Crit Care Med. 2002 Sep 15;166(6):855-9
references: 12231497
references: Sleep. 1996 Jun;19(5):378-81
references: 8843528
references: Can Respir J. 2008 Oct;15(7):365-9
references: 18949106
references: Ann Intern Med. 2009 Nov 17;151(10):696-702
references: 19920270
references: Sleep. 2006 Mar;29(3):375-80
references: 16553024
references: J Psychosom Res. 2002 Jul;53(1):617-23
references: 12127180
references: Sleep. 2005 Sep;28(9):1049-57
references: 16268373
references: Diabetes Care. 2009 Nov;32(11):1980-5
references: 19641160
references: Sleep. 2008 Sep;31(9):1310-6
references: 18788656
references: J Clin Sleep Med. 2009 Jun 15;5(3):263-76
references: 19960649
references: Chest. 1994 Feb;105(2):429-33
references: 8306741
references: J Allergy Clin Immunol. 1997 Feb;99(2):S750-6
references: 9042067
references: Am J Respir Crit Care Med. 1994 Jan;149(1):149-54
references: 8111574
references: Am Rev Respir Dis. 1993 Apr;147(4):887-95
references: 8466125
references: J Psychosom Res. 2009 Aug;67(2):135-41
references: 19616140
references: Sleep. 2001 Jun 15;24(4):411-7
references: 11403525
references: Sleep Breath. 2012 Jun;16(2):295-304
references: 21445659
references: Chest. 1999 Mar;115(3):863-6
references: 10084504
references: Respiration. 2005 Sep-Oct;72(5):458-9
references: 16210882
references: Sleep Breath. 2004 Mar;8(1):15-29
references: 15026935
references: Am J Respir Crit Care Med. 1999 Feb;159(2):461-7
references: 9927358
references: Sleep Med Rev. 2010 Feb;14(1):9-15
references: 19640748
references: J Clin Sleep Med. 2005 Apr 15;1(2):125-8
references: 17561624
references: Chest. 2009 Nov;136(5):1263-1268
references: 19567493
references: Sleep. 2008 Nov;31(11):1527-33
references: 19014072
references: Ann Intern Med. 2001 Jun 5;134(11):1015-23
references: 11388814
references: Sleep Med. 2010 Sep;11(8):772-6
references: 20673741
references: Sleep. 1992 Aug;15(4):302-5
references: 1519003
references: Sleep. 2009 Aug;32(8):1027-37
references: 19725254
references: Psychiatr Pol. 1994 May-Jun;28(3 Suppl):33-44
references: 8090852