Insomnia and Obstructive Sleep Apnea: The Role of COMISA in Cardiology

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.

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