Behavioural and insomnia features impact on daytime sleepiness in patients with sleep apnoea

oDaytime sleepiness in people with suspected obstructive sleep apnoea is being regularly attributed to the existing respiratory distress during a night’s sleep of affected individuals. Novel evidence from a trial that included 230 individuals and took place at the Sleep Medicine & Neurostimulation Centre at the Dept. of Otorhinolaryngology of the University Medical Centre Mainz suggests that sleep specialists should pay particular attention to behavioural and insomnia–related traits when assessing people with sleep apnoea in the future. This means that physicians or other specialists caring for people with sleep apnoea should spend some extra time to better get to know the everyday routines, the minds and the hearts of these people. Such a practice may potentially improve the clinical management of sleep apnoea patients considerably.

More specifically, the item 2-, 4-, 7- scores as well as the total score of the insomnia severity index questionnaire did correlate strongly and significantly with the subjective, regularly used in sleep medicine everyday routine practice, Epworth Sleepiness Scale score. The Insomnia Severity Index questionnaire has been previously developed to capture insomnia features in people presenting with sleep-related problems and has been mainly used by psychologists and psychiatrists treating people suspected of suffering from insomnia or related conditions.

Item 2 of this questionnaire refers to the difficulty staying asleep, Item 4 to the subjective satisfaction with own current sleep patterns, and Item 7 treats the interference of sleep problems with daily functions.

On the contrary, full-night standard polysomnography-associated metrics related to breathing and to respiratory physiology (such as the frequency of apnoeas and hypopnoeas, the degree of oxygen desaturations or the frequency of arousals during sleep) did not correlate at all with the subjective patient – reported sleepiness, as captured by the Epworth scale, in these people.

Apparently, human nature does not distinguish between apnoea, respiratory distress, behavioural issues and insomnia when it comes to sleep and sleep routines impacting on daytime functioning and well-being. Healthcare specialists trying to help such people may keep this issue in their minds.

From a scientific and societal perspective, these findings are just one further example that showcases the necessity of crossing intrinsic scientific borders and underpins the significance of interdisciplinary approaches to studying sleep disorders.

This research has been published a few weeks ago in Sleep Medicine and is available to everyone interested in an open-access format under (https://doi.org/10.1016/j.sleep.2025.02.035).

Therefore, insomnia and behavioural issues may be increasingly considered as key factors when evaluating sleepiness in people with sleep apnoea in the clinical setting in the future.