Abstract

Introduction

Evidence suggests that insomnia and obstructive sleep apnea (OSA) frequently coexist. It is unclear whether the impact is different between younger and older adults. This study compared sleep outcomes between younger and older adults with comorbid OSA and insomnia.

Methods

Using a cross-sectional design, baseline data from the Diabetes Sleep Treatment Trial, an ongoing randomized placebo-controlled trial evaluating the effect of OSA treatment on glucose control and diabetes self-management, was used to examine a subsample of participants with OSA (determined by ApneaLink Plus®, apnea-hypopnea index [AHI] ≥5) and insomnia (Insomnia Severity Index [ISI] ≥10). Sleep outcomes were measured using the Pittsburgh Sleep Quality Index (PSQI; global and factor scores [Sleep Efficiency, Perceived Sleep Quality, and Daily Disturbance]; higher scores = worse sleep quality), and the Functional Outcomes of Sleep Questionnaire (FOSQ; total score and 5 subscales [Activity Level, Vigilance, Intimacy and Sexual Relationships, General Productivity, and Social Outcomes]; higher scores = better functional status). Chi-square and Mann-Whitney U tests were used to compare sleep outcomes between younger (<65 years [73.2%, n=71]) and older adults (≥65 years [26.8%, n=26]).

Results

The sample (N=97) was 35.1% non-White, 45.4% female, and on average, 57.6±10.6 years of age with a mean of BMI 36.6±7.2kg/m2 and mean A1C 7.9±1.5%. No significant differences were found between older and younger adults regarding sex, marital status, race, education level, financial status (all p-values >.05). There were no significant difference (p >.05) in insomnia, OSA severity, or PSQI global scores between groups. PSQI Daily Disturbance factor score were higher, on average, in younger adults (p= .03). Younger adults had significantly lower FOSQ total scores (p= .03) and lower General Productivity (p= .001), Activity Level (p= .01) and Vigilance (p= .012) subscales scores.

Conclusion

The impact of impaired sleep due to comorbid OSA and insomnia may be expressed differently between younger and older adults. Further examination of the impact of severity of comorbid OSA and insomnia on outcomes in both younger and older adults is needed.

Support (If Any)

R01-DK096028; ApneaLinks: ResMed.

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