Talking Sleep Season 5 | Episode 4

Comorbid insomnia and sleep apnea (COMISA)

Dr. Alexander Sweetman, GUEST

An article published in ERJ Open Research demonstrates that cognitive behavioral therapy for insomnia (CBT-I) consolidates sleep periods and promotes a 15% decrease in OSA severity in patients with COMISA. Our guest, Alexander Sweetman, PhD, is here to tell us more.

Dr. Alexander Sweetman is Program Manager of a sleep disorder education and implementation program with the Australasian Sleep Association, and has academic status at Flinders University. He is interested in the co-morbidity of insomnia and obstructive sleep apnea (COMISA), and in improving the management of sleep disorders throughout the healthcare system. During his PhD, he coined the term “COMISA”, led a multi-site randomised controlled trial to understand the most effective treatment approach for COMISA, and contributed to this new field of sleep medicine. He has led several clinical trials and epidemiological studies to investigate the prevalence, consequences, and most effective treatment approaches for people with COMISA. He is chair of the Australasian Sleep Association psychologist education committee and is developing a CBT-i training program for Australian psychologists. He has developed and is currently testing a digital CBT-i program in different settings and populations.

Episode Resources

  1. COMISA figures
  2. Sweetman A, Lack L, McEvoy RD, Antic NA, Smith S, Chai-Coetzer CL, Douglas J, O’Grady A, Dunn N, Robinson J, Paul D, Eckert D, Catcheside PG. Cognitive behavioural therapy for insomnia reduces sleep apnoea severity: a randomised controlled trial. ERJ Open Res. 2020 May 17;6(2):00161-2020.
  3. Lechat B, Appleton S, Melaku YA, Hansen K, McEvoy RD, Adams R, Catcheside P, Lack L, Eckert DJ, Sweetman A. Comorbid insomnia and sleep apnoea is associated with all-cause mortality. Eur Respir J. 2022 Jul 13;60(1):2101958.
  4. Sweetman A, Lack L, McEvoy RD, et al. Effect of depression, anxiety, and stress symptoms on response to cognitive behavioral therapy for insomnia in patients with comorbid insomnia and sleep apnea: a randomized controlled trial. J Clin Sleep Med. 2021;17(3):545–554.
  5. Eckert DJ, Sweetman A. Impaired central control of sleep depth propensity as a common mechanism for excessive overnight wake time: implications for sleep apnea, insomnia and beyond. J Clin Sleep Med. 2020;16(3):341–343.
  6. Sweetman A, Lack L, McEvoy D. Refining the measurement of insomnia in patients with obstructive sleep apnea. J Clin Sleep Med. 2019;15(12):1717–1719.