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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">systhiper</journal-id><journal-title-group><journal-title xml:lang="ru">Системные гипертензии</journal-title><trans-title-group xml:lang="en"><trans-title>Systemic Hypertension</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2075-082X</issn><issn pub-type="epub">2542-2189</issn><publisher><publisher-name>LLC «ИнтерМедсервис»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.38109/2075-082X-2026-2-41-47</article-id><article-id custom-type="elpub" pub-id-type="custom">systhiper-880</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW</subject></subj-group></article-categories><title-group><article-title>Инсомния и обструктивное апноэ сна: место COMISA в кардиологии</article-title><trans-title-group xml:lang="en"><trans-title>Insomnia and Obstructive Sleep Apnea: The Role of COMISA in Cardiology</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3609-2504</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Михайлова</surname><given-names>О. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Mikhailova</surname><given-names>O. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Михайлова Оксана Олеговна, к.м.н., научный сотрудник, лаборатория апноэ сна, отдел гипертонии</p><p>ул. Академика Чазова, д. 15 а, г. Москва 121552</p></bio><bio xml:lang="en"><p>Oksana O. Mikhailova, Cand. Sci. (Med.), Researcher, the Sleep Laboratory, Hypertension Department</p><p>15a Acad. Chazova str., Moscow 121552</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3140-5030</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Елфимова</surname><given-names>Е. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Elfimova</surname><given-names>E. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елфимова Евгения Михайловна, к.м.н., старший научный сотрудник, лаборатория апноэ сна, отдел гипертонии</p><p>ул. Академика Чазова, д. 15 а, г. Москва 121552</p></bio><bio xml:lang="en"><p>Evgeniya M. Elfimova, Cand. Sci. (Med.), Senior Researcher, the Sleep Laboratory, Hypertension Department</p><p>15a Acad. Chazova str., Moscow 121552</p></bio><email xlink:type="simple">eelfimova@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5918-9969</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Литвин</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Litvin</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Литвин Александр Юрьевич, д.м.н., главный научный сотрудник, руководитель лаборатории апноэ сна, отдел гипертонии</p><p>ул. Академика Чазова, д. 15 а, г. Москва 121552</p></bio><bio xml:lang="en"><p>Alexandr Yu. Litvin, Dr. Sci. (Med.), Professor, Chief of the Sleep Laboratory, Hypertension Department</p><p>15a Acad. Chazova str., Moscow 121552</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9822-4357</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чазова</surname><given-names>И. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Chazova</surname><given-names>I. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чазова Ирина Евгеньевна, академик РАН, профессор, д.м.н., руководитель отдела гипертонии, заместитель генерального директора по научно-экспертной работе</p><p>ул. Академика Чазова, д. 15 а, г. Москва 121552</p></bio><bio xml:lang="en"><p>Irina E. Chazova, Dr. Sci. (Med.), Professor, Acad. of RAS, Chief of the Hypertension Department</p><p>15a Acad. Chazova str., Moscow 121552</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр кардиологии имени академика Е.И. Чазова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>E.I. Chazov National Medical Research Center of Cardiology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>27</day><month>06</month><year>2026</year></pub-date><volume>23</volume><issue>2</issue><fpage>41</fpage><lpage>47</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Михайлова О.О., Елфимова Е.М., Литвин А.Ю., Чазова И.Е., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Михайлова О.О., Елфимова Е.М., Литвин А.Ю., Чазова И.Е.</copyright-holder><copyright-holder xml:lang="en">Mikhailova O.O., Elfimova E.M., Litvin A.Y., Chazova I.E.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.syst-hypertension.ru/jour/article/view/880">https://www.syst-hypertension.ru/jour/article/view/880</self-uri><abstract><p>Сочетание инсомнии и обструктивного апноэ сна (СОМІSА) является распространенным феноменом в клинической практике, однако его влияние на сердечно-сосудистую систему длительное время недооценивалось. В представленном обзоре систематизированы данные об общих патофизиологических механизмах СОМІSА и сердечно-сосудистых заболеваний (ССЗ), оценено влияние данных нарушений сна на течение ССЗ и их прогноз, представлена информация о существующих и перспективных тактиках лечения. Анализ различных исследований показывает, что СОМІSА ассоциировано с более высоким риском развития артериальной гипертонии и сердечно-сосудистых осложнений, в сравнении с изолированной инсомнией или апноэ сна. Важно, что данное состояние является потенциально модифицируемым: комплексный подход, включающий когнитивноповеденческую терапию инсомнии и ПАП-терапию, демонстрирует бóльшую эффективность в отношении улучшения качества сна и приверженности лечению по сравнению с монотерапией. Своевременной диагностике обоих нарушений сна и их комбинированному лечению в настоящее время не уделяется должного внимания. В связи с этим данный вопрос остается актуальным, а его решение может способствовать дополнительному снижению сердечно-сосудистого риска.</p></abstract><trans-abstract xml:lang="en"><p>The combination of insomnia and obstructive sleep apnea (COMISA) is a common clinical phenomenon. However, its impact on the cardiovascular system has long been underestimated. This review systematizes data on the pathophysiological mechanisms of COMISA and cardiovascular disease (CVD), assesses the impact of these sleep disorders on the course and prognosis of CVD, and presents information on existing and promising treatment strategies. An analysis of various studies shows that COMISA is associated with a higher risk of developing hypertension and cardiovascular complications compared to isolated insomnia or sleep apnea. This condition is potentially modifiable: a comprehensive approach including cognitive-behavioral therapy for insomnia and PAP therapy demonstrates greater efficacy in improving sleep quality and treatment adherence compared to monotherapy. Timely diagnosis of both sleep disorders and their combined treatment remain underestimated. Therefore, this issue is relevant, and its resolution could help to reduce cardiovascular risk.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>СOMISA</kwd><kwd>коморбидная инсомния и обструктивное апноэ сна</kwd><kwd>инсомния</kwd><kwd>обструктивное апноэ сна</kwd><kwd>сердечно-сосудистые заболевания</kwd><kwd>артериальная гипертония</kwd><kwd>когнитивно-поведенческая терапия инсомнии</kwd><kwd>ПАП-терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>COMISA</kwd><kwd>comorbid insomnia and obstructive sleep apnea</kwd><kwd>insomnia</kwd><kwd>obstructive sleep apnea</kwd><kwd>cardiovascular disease</kwd><kwd>hypertension</kwd><kwd>cognitive behavioral therapy of insomnia</kwd><kwd>PAP therapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Benjafield A, Ayas N, Eastwood P et al. 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