Adherence
Administering Cognitive Behavioral Therapy for Insomnia (CBTi) prior to Continuous Positive Airway Pressure (CPAP) therapy significantly improves insomnia symptoms and increases long-term CPAP adherence in patients with Co-morbid Insomnia and Sleep Apnea (COMISA) compared to CPAP alone or no treatment.
If you have both sleep apnea and insomnia, treating them separately often fails. The most effective strategy is to start with Cognitive Behavioral Therapy for Insomnia (CBTi) delivered by a therapist before or alongside starting CPAP. This approach not only fixes your sleeplessness but also helps you stick with your CPAP machine longer, leading to better overall health outcomes than using CPAP alone.
our recent RCT data from 145 COMISA patients with moderate and severe OSA, indicated that CBTi leads to greater improvement in ISI scores, diary-measured sleep parameters, and dysfunctional beliefs and attitudes about sleep by post-treatment, compared to a no-treatment control group... subsequently showed greater initial acceptance of CPAP, and 61 min greater use by 6 months follow-up
Why this rating
Based on multiple Randomized Controlled Trials (RCTs) and chart reviews cited, though some show mixed results depending on delivery method (self-help vs. therapist).
Source
Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials
Alexander Sweetman et al. · Brain Sciences · 2019
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