Insomnie et syndrome d'apnée obstructive du sommeil : une liaison dangereuse

Obstructive sleep apnea (OSA) and insomnia are the two most common sleep disorders among adults and often coexist. Some recent studies have shown that each disorder has an impact on the other. The pathophysiological mechanisms underlying this effect are unclear. The OSA therapy by continuous positive airway pressure (CPAP) may have a negative effect on insomnia symptoms and, conversely, the treatment of insomnia might increase the OSA symptoms and decrease the compliance to CPAP. Treating this comorbidity is complex and requires a global approach. Thus, it is recommended to perform a polysomnography in case of OSA symptoms among patients with insomnia and to evaluate (with the insomnia severity index) and treat the insomnia before initiating the CPAP treatment. Then the residual insomnia symptoms can be managed with specific treatment.