The Sleepless OSA Patient: What Dental Sleep Providers Need to Know about COMISA (Live)

Comorbid insomnia and sleep apnea (COMISA) affects approximately 30% to 50% of patients with obstructive sleep apnea (OSA) and is often underrecognized despite its significant clinical impact. Rather than simply representing the coexistence of two sleep disorders, COMISA is a distinct condition in which insomnia and OSA interact bidirectionally, contributing to hyperarousal, unstable breathing patterns, and disrupted sleep.

Patients with untreated COMISA experience worse health outcomes, including increased cardiovascular and metabolic risks, impaired daytime functioning, and lower adherence to treatments such as CPAP and oral appliance therapy. For dental sleep medicine practitioners, recognizing COMISA early is critical to selecting appropriate patients, improving treatment acceptance, and achieving better long-term results.

This presentation reviews the underlying physiology and unique challenges of COMISA and provides practical approaches for identifying insomnia symptoms in patients with OSA. By improving detection and management of COMISA, clinicians can better address patient needs and support more successful treatment outcomes.

Objectives

1. Review the unique physiology of comorbid insomnia and sleep apnea (COMISA)
2. Understand the impact of untreated COMISA on patient health and treatment success
3. Identify ways to identify and manage COMISA in the dental sleep practice