{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T19:46:05Z","timestamp":1777059965465,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Insomnia and sleep\u2010disordered breathing (SDB) are prevalent sleep disorders. These disorders can therefore be concurrently present \u2013 comorbid insomnia and sleep apnea (COMISA). The prevalence of COMISA in the paediatric age range is unclear. As such, phenotypic constructs should help better define this comorbid condition if it exists in children and improve both diagnostic sensitivity and ultimately clinical care outcomes. We aimed to evaluate the frequency of insomnia in children and adolescents referred for evaluation of sleep symptoms suggestive of SDB in one initial (Cohort#1) and verify such findings in an independent cohort (Cohort#2) using a retrospective cross\u2010sectional approach in patients aged 9\u201319\u2009years presenting at a sleep centre to be evaluated for symptoms of SDB. Cohort #1 comprised 50 consecutive children (58% males; mean [SD] age 13.6\u00a0[3.3]\u00a0years; median [interquartile range, IQR] Epworth Sleepiness Scale score 10\u00a0[6\u201312]) who were evaluated using validated SDB and insomnia questionnaires. Cohort#2 was extracted from electronic medical records and included 384 polysomnographically evaluated children (mean [SD] age 12.9\u00a0[3.6]\u00a0years; mean [SD] body mass index z score 1.27\u00a0[0.28]; median Epworth Sleepiness Scale score 9.7\u00a0[4\u201317]). In Cohort #1, 56% were at high risk of SDB, 36% had insomnia alone, and 18% were at high risk of COMISA. The prevalence of COMISA in Cohort #2 was 16%, 72% had SDB alone, and 12% had insomnia alone. In both cohorts, COMISA manifested as increased propensity for sleepiness and fatigue during both waking and daytime. Thus, the presence of COMISA is frequent in the paediatric age range and accompanied by a more prominent symptomatic phenotype.<\/jats:p>","DOI":"10.1111\/jsr.13705","type":"journal-article","created":{"date-parts":[[2022,8,27]],"date-time":"2022-08-27T05:27:53Z","timestamp":1661578073000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Comorbid insomnia and sleep apnea in children: a preliminary explorative study"],"prefix":"10.1111","volume":"32","author":[{"given":"Miguel","family":"Meira e Cruz","sequence":"first","affiliation":[{"name":"Sleep Unit Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine  Lisbon Portugal"},{"name":"International Center on Clinical Sleep Medicine and Research Bahiana School of Medicine and Public Health  Salvador Brazil"},{"name":"European Sleep Center  Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Salles","sequence":"additional","affiliation":[{"name":"International Center on Clinical Sleep Medicine and Research Bahiana School of Medicine and Public Health  Salvador Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luana","family":"Seixas","sequence":"additional","affiliation":[{"name":"International Center on Clinical Sleep Medicine and Research Bahiana School of Medicine and Public Health  Salvador Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"D\u2032Elia","sequence":"additional","affiliation":[{"name":"European Sleep Center  Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Rocha","sequence":"additional","affiliation":[{"name":"Cardiovascular Autonomic Function Lab Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine  Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8195-6036","authenticated-orcid":false,"given":"David","family":"Gozal","sequence":"additional","affiliation":[{"name":"Department of Child Health University of Missouri School of Medicine  Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"American Academy of Sleep Medicine.International Classification of Sleep Disorders \u2013 Third Edition (ICSD\u20103). 3rd ed. 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