Authors:	Bahr, Katharina Cámara, Rafael J. A. Gouveris, Haralampos Tuin, Inka
Title:	Current treatment of comorbid insomnia and obstructive sleep apnea with CBTI and PAP-therapy : a systematic review
Online publication date:	8-Jan-2019
Year of first publication:	2018
Language:	english
Abstract:	Insomnia and obstructive sleep apnea (OSA) are often both present in patients with sleep- disordered-breathing. The coexistence of the two disorders shows an increase in cumulative morbidity and an overall greater illness severity. There is still considerable controversy regarding management decisions in this group of patients. This systematic review focused on more recent evidence regarding treatment of patients presenting with both clinical entities of comorbid insomnia and obstructive sleep apnea in terms of their management, especially using combinations of positive airway pressure (PAP, namely aPAP, cPAP, adaptive servo-ventilation[ASV]) and CBTi as well as each one of these two modalities alone. As a conclusion it is necessary to specifically target distinct combinations of both insomnia (initial, middle, late) and OSA (mild, moderate, severe) phenotypes. The present review gives reason to assume that both CBTi and PAP-therapy are necessary. However, it appears that distinct treatment patterns may suit different COMISA phenotypes.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-272
URN:	urn:nbn:de:hebis:77-publ-587613
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Frontiers in neurology 9
Pages or article number:	Art. 804
Publisher:	Frontiers Research Foundation
Publisher place:	Lausanne
Issue date:	2018
ISSN:	1664-2295
Publisher URL:	http://dx.doi.org/10.3389/fneur.2018.00804
Publisher DOI:	10.3389/fneur.2018.00804
Appears in collections:	JGU-Publikationen