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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Patients with both obstructive sleep apnea (OSA) and insomnia see significantly greater blood pressure reductions after CPAP therapy than those with OSA alone. A new study in CHEST found a 6 mmHg drop in 24-hour systolic BP in the combined group vs. just 0.3 mmHg in OSA-only patients. The findings point to insomnia as a key marker for identifying who benefits most from CPAP.
Patients juggling both obstructive sleep apnea (OSA) and insomnia — a combo known as COMISA — may have more to gain from CPAP therapy than previously appreciated. A prospective cohort study published in CHEST found that after just four weeks of auto-CPAP, adults with COMISA experienced significantly larger drops in systolic blood pressure across the board compared to those with OSA alone.
The study followed 71 adults with OSA and elevated blood pressure. Those with comorbid insomnia saw their 24-hour systolic BP fall by 6 mmHg — well above the 5 mmHg threshold considered clinically meaningful — while the OSA-only group barely budged at 0.3 mmHg. Nocturnal BP showed the most dramatic difference, and insomnia symptoms at baseline were independently associated with a fivefold increase in the odds of achieving a clinically meaningful BP reduction.
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Why it matters: These findings suggest that insomnia isn't just a nuisance comorbidity — it may actually flag patients who stand to gain the most cardiovascular benefit from CPAP. Clinicians could use this insight to prioritize and personalize treatment, while also pairing CPAP with insomnia-targeted interventions to maximize outcomes.
