{"doi":"10.1111/jsr.13563","title":"The association of co‐morbid insomnia and sleep apnea with prevalent cardiovascular disease and incident cardiovascular events","abstract":"Insomnia and obstructive sleep apnea commonly co-occur (co-morbid insomnia and sleep apnea), and their co-occurrence has been associated with worse cardiometabolic and mental health. However, it remains unknown if people with co-morbid insomnia and sleep apnea are at a heightened risk of incident cardiovascular events. This study used longitudinal data from the Sleep Heart Health Study (N = 5803) to investigate potential associations between co-morbid insomnia and sleep apnea and cardiovascular disease prevalence at baseline and cardiovascular event incidence over ~11 years follow-up. Insomnia was defined as self-reported difficulties initiating and/or maintaining sleep AND daytime impairment. Obstructive sleep apnea was defined as an apnea-hypopnea index ≥ 15 events per hr sleep. Co-morbid insomnia and sleep apnea was defined if both conditions were present. Data from 4160 participants were used for this analysis. The prevalence of no insomnia/obstructive sleep apnea, insomnia only, obstructive sleep apnea only and co-morbid insomnia and sleep apnea was 53.2%, 3.1%, 39.9% and 1.9%, respectively. Co-morbid insomnia and sleep apnea was associated with a 75% (odd ratios [95% confidence interval]; 1.75 [1.14, 2.67]) increase in likelihood of having cardiovascular disease at baseline after adjusting for pre-specified confounders. In the unadjusted model, co-morbid insomnia and sleep apnea was associated with a twofold increase (hazard ratio, 95% confidence interval: 2.00 [1.33, 2.99]) in risk of cardiovascular event incidence. However, after adjusting for pre-specified covariates, co-morbid insomnia and sleep apnea was not significantly associated with incident cardiovascular events (hazard ratio 1.38 [0.92, 2.07]). Comparable findings were obtained when an alternative definition of insomnia (difficulties initiating and/or maintaining sleep without daytime impairment) was used.","journal":"Journal of Sleep Research","year":2022,"id":237322,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":61,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9265,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":858867,"name":"Sarah Appleton","orcid":"0000-0001-7292-9714","position":1,"is_corresponding":false},{"id":22662,"name":"Yohannes Adama Melaku","orcid":"0000-0002-3051-7313","position":2,"is_corresponding":false},{"id":859248,"name":"Kristy L. Hansen","orcid":"0000-0003-2400-6207","position":3,"is_corresponding":false},{"id":484480,"name":"R. Doug McEvoy","orcid":"0000-0002-5759-0094","position":4,"is_corresponding":false},{"id":859249,"name":"Robert Adams","orcid":"0000-0001-6254-0385","position":5,"is_corresponding":false},{"id":484477,"name":"Peter Catcheside","orcid":"0000-0002-9372-6788","position":6,"is_corresponding":false},{"id":859250,"name":"Leon Lack","orcid":"0000-0002-8505-5873","position":7,"is_corresponding":false},{"id":665266,"name":"Danny J. Eckert","orcid":"0000-0003-3503-2363","position":8,"is_corresponding":false},{"id":858871,"name":"Alexander Sweetman","orcid":"0000-0002-7900-1414","position":9,"is_corresponding":false},{"id":858866,"name":"Bastien Lechat","orcid":"0000-0003-0760-0714","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":null,"created_at":"2026-07-19T00:22:08.925400Z","pmid":"35166401","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}