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Editorials |

Can’t Sleep? : You May Have Sleep Apnea!

Nancy A. Collop, MD, FCCP
Author and Funding Information

Affiliations: Jackson, MS 
 ,  Dr. Collop is Professor of Medicine, Division of Pulmonary/Critical Care, University of Mississippi Medical Center.

Correspondence to: Nancy Collop, MD, FCCP, Professor of Medicine, Division of Pulmonary/Critical Care, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39216; e-mail: ncollop@aol.com



Chest. 2001;120(6):1768-1769. doi:10.1378/chest.120.6.1768
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In this issue of CHEST (see page 1923), Krakow et al examine the prevalence of symptoms of insomnia in patients with sleep-disordered breathing. In this retrospective analysis from their university sleep-disorders laboratory, they found that 50% of those studied had insomnia symptoms. Insomnia symptoms were defined as a yes answer to two or more of three questions, including: (1) does it take > 30 min to fall asleep? (2) do you wake up a lot? or (3) if awakened, is it difficult returning to sleep? Their findings complement an earlier report1 studying older adults with insomnia, who had a prevalence of obstructive sleep apnea (OSA) ranging from 29 to 43%, depending on the apnea-hypopnea index (AHI). Although better designed studies are needed to confirm these findings, they do raise an important issue concerning our approach to patients with these disorders. Despite the fact that sleep apnea is listed in the differential diagnosis of insomnia in the textbook, Principles and Practice of Sleep Medicine,2 clinicians are taught that most patients with insomnia do not need polysomnography. Moreover, the majority of insurance companies will not pay for a sleep study if it is ordered as part of an insomnia evaluation. The findings of Krakow et al suggest this position may need review.

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