ORCID

0000-0001-8425-8778 (Sanford)

Document Type

Article

Publication Date

2025

DOI

10.1186/s12931-025-03193-x

Publication Title

Respiratory Research

Volume

26

Issue

1

Pages

139 (1-13)

Abstract

Background

Chronic insomnia and obstructive sleep apnea commonly co-occur. Few studies have explored the neurophysiological and neurocognitive characteristics of COMISA, which could help guide improving treatment diagnostic tools and determining novel therapeutic targets. This study aims to explore the neurophysiological and neurocognitive characteristics of COMISA using electroencephalographic (EEG) spectral analysis and subjective and objective neurocognitive measurements.

Methods

Participants were from our community recruited OSA-insomnia-COMISA cohort with 206 included for our current analysis including 74 chronic insomniacs (CIs), 55 OSA patients and 77 COMISA patients. Standard polysomnography (PSG) and multiple sleep latency tests (MSLTs) were recorded and used to obtain relative EEG spectral power in each sleep stage during PSG and each session during MSLTs. A series of subjective and objective neurocognitive tests were conducted to evaluate executive function, attention, retrospective and prospective memory and meta-cognition.

Results

In PSG and MSLTs, COMISA patients showed combined EEG power characteristics of both CIs and OSA. Specifically, COMISA patients exhibited similar EEG spectral characteristics to CIs, with decreased delta and increased alpha and beta power in NREM sleep stages, and increased beta power in REM and MSLTs. Similar to the EEG spectral power profile of OSA, COMISA patients showed increased delta power in REM and MSLTs. Compared to OSA patients, COMISA patients exhibited worse subjectively measured attention and meta-cognition related to negative beliefs about uncontrollability and danger of worry (NEG), which were positively associated with ISI scores.

Conclusions

The EEG spectral power characteristics of COMISA patients in overnight PSG and daytime MSLT appear to be the manifestation of elements of both CIs and OSA. However, the neurocognitive features of COMISA patients in subjectively measured attention and NEG meta-cognition were primarily affected by chronic insomnia.

Rights

© The Authors 2025.

This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Data Availability

Article states: "The datasets used and analyzed during the current study are available from the corresponding author on reasonable request."

Original Publication Citation

Shi, Y., Nie, Y., Hao, F., Feng, X., Zhang, Y., Sanford, L. D., Ren, R., & Tang, X. (2025). EEG spectral analysis of nighttime sleep and daytime MSLTs and neurocognitive evaluations in subjects with co-morbid insomnia and OSA. Respiratory Research, 26(1), 1-13, Article 139. https://doi.org/10.1186/s12931-025-03193-x

Additional Files
12931_2025_3193_MOESM1_ESM.docx (1309 kB)
Supplementary Material 1
Download

Share

COinS