title: Prevalence of excessive sleepiness is higher whereas insomnia is lower with greater severity of obstructive sleep apnea.
abstract: OBJECTIVE
  The objective of the present study was to investigate the prevalence of insomnia and excessive sleepiness in relation to the presence and severity of obstructive sleep apnea (OSA).
  
  
  METHODS
  The sample consisted of patients referred to a university hospital on suspicion of OSA. In total, 1115 patients with mean age of 48 years were studied. Insomnia (Bergen Insomnia Scale) and excessive sleepiness (Epworth Sleepiness Scale) were diagnosed using validated questionnaires. The insomnia scale permits diagnosing insomnia using both old and new (from 2014) criteria. OSA was diagnosed and categorized based on a standard respiratory polygraphic sleep study using a type 3 portable monitor.
  
  
  RESULTS
  OSA was diagnosed in 59.4 % of the referred patients. The prevalence of excessive sleepiness was higher with greater severity of OSA: 40.5 % in the patients without OSA (apnea-hypopnea index (AHI) <5), 46.5 % in mild OSA (AHI 5-14.9), 52.0 % in moderate OSA (AHI 15-29.9), and 58.0 % in severe OSA (AHI 30 or above). In contrast, the prevalence of insomnia using the 2014 diagnostic criteria showed an opposing prevalence: 54.2 % no OSA, 54.9 % mild OSA, 48.5 % moderate OSA, and 44.6 % severe OSA. Logistic and linear regression analyses showed that sleepiness was positively associated whereas insomnia was negatively associated with OSA severity and AHI.
  
  
  CONCLUSIONS
  Both excessive sleepiness and insomnia were seen in high proportions of the patients referred on suspicion of OSA. Excessive sleepiness was higher whereas insomnia was lower with greater OSA severity.
authors: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway. bjorn.bjorvatn@isf.uib.no.|Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway. bjorn.bjorvatn@isf.uib.no.
authors: Bjørn
authors: B
authors: Bjorvatn
authors: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.|Section of Thoracic Medicine, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors: Sverre
authors: S
authors: Lehmann
authors: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.|Department of Otolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
authors: Shashi
authors: S
authors: Gulati
authors: Section of Clinical Neurophysiology, Department of Neurology, Haukeland University Hospital, Bergen, Norway.|Department of Clinical Medicine, University of Bergen, Bergen, Norway.
authors: Harald
authors: H
authors: Aurlien
authors: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.|Department of Psychosocial Science, University of Bergen, Bergen, Norway.
authors: Ståle
authors: S
authors: Pallesen
authors: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
authors: Ingvild W
authors: IW
authors: Saxvig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Excessive sleepiness; Hypersomnia; Insomnia; OSA; Sleep apnea