{
  "abstract": "Introduction Comorbid insomnia and sleep apnoea (COMISA) are thought to have a prevalence rate of 30-40% and are associated with increased symptom burden, poorer daytime functioning and reduced adherence to continuous positive airway pressure (CPAP) therapy. However, insomnia is not routinely screened for in many OSA pathways. The NICE-approved Sunrise mandibular jaw movement sensor provides a home-based alternative to traditional sleep testing and generates Artificial Intelligence derived estimates of the apnoea–hypopnoea index (AHI), arousal burden and respiratory effort metrics. The Sunrise app incorporates the Insomnia Severity Index (ISI). This audit examined the relationship between AHI, insomnia severity and secondary physiological indices in adults undergoing a single-night Sunrise assessment.Methods Forty-one adults with suspected OSA completed a Sunrise test. The device produced AHI, arousal index and respiratory effort as a percentage of total sleep time (RE%TST). Participants self reported their ISI within the Sunrise app. Pearson correlations explored relationships between AHI, ISI and secondary measures. COMISA prevalence was calculated using ISI thresholds ≥10, ≥14 and ≥15 to reflect varying definitions of clinically relevant insomnia.Results Mean AHI was 22.3 events/hour, with 62% of participants classified as having moderate–severe OSA in this cohort. Insomnia symptoms were common (mean ISI 15.5). AHI and ISI were not correlated (r = 0.009), indicating that insomnia severity was independent of OSA severity. COMISA prevalence remained high across thresholds: 84.6% (ISI ≥10), 71.8% (ISI ≥14) and 64.1% (ISI ≥15) figure 1. ISI showed a moderate correlation with the arousal index (r = 0.316) and a weak association with RE%TST (mean 61.9%), suggesting that sleep fragmentation and sustained respiratory effort may be more closely linked to insomnia symptoms than the number of apnoea–hypopnoea events.Conclusion Insomnia severity did not relate to OSA severity despite high COMISA rates. Measures of sleep disruption, particularly arousal index burden, appeared more relevant to subjective insomnia than AHI alone. These findings suggest inclusion of routine insomnia screening within OSA diagnostic pathways and highlight the potential value of combining CPAP therapy with cognitive behavioural therapy for insomnia (CBT-I). Limitations include the small sample size, single-night recordings and reliance on self-reported insomnia symptoms.Abstract P34 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Sefam Medical Ltd, Dumfries, United Kingdom"
      ],
      "name": "Phyllis Murphie"
    },
    {
      "affiliations": [
        "Sefam Medical Ltd, Dumfries, United Kingdom"
      ],
      "name": "Lorna McKay"
    }
  ],
  "title": "P34 The prevalence of self-reported COMISA in a prospective audit of people who have had a NICE approved sunrise sleep test",
  "uid": "7412e3bf-eabd-5ca3-92da-b9f20ea9d451"
}