Trial reportSleep2021
Randomized controlled trial of an integrated approach to treating insomnia and improving the use of positive airway pressure therapy in veterans with comorbid insomnia disorder and obstructive sleep apnea.
Trial report in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02027558 (Novel Treatment of Comorbid Insomnia and Sleep Apnea in Older Veterans), which is not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Novel Treatment of Comorbid Insomnia and Sleep Apnea in Older Veterans
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Content Comparison of Quality-of-Life Instruments Used in Economic Evaluations of Sleep Disorder Interventions: A Systematic Review.PharmacoEconomics · 2024Pooled it
- Content Comparison of Quality-of-Life Instruments Used in Economic Evaluations of Sleep Disorder Interventions: A Systematic Review.PharmacoEconomics · 2024Pooled it
- The Effect of Digital Cognitive Behavioural Therapy for Insomnia in People With Co-Morbid Insomnia and Sleep Apnoea (COMISA): A Pilot Randomised Controlled Trial.Journal of sleep research · 2026Trial
- Cognitive Behavioral Therapy Alone or in Combination with Eszopiclone in Comorbid Insomnia and Obstructive Sleep Apnea in Veterans with Posttraumatic Stress Disorder: A Randomized Trial.The Psychiatric quarterly · 2025Trial
- Daytime symptom trajectories among adults with stable heart failure and insomnia: evidence from a randomised controlled trial of cognitive behavioural therapy for insomnia.Journal of sleep research · 2024Trial
- Trial
- A randomized controlled trial of cognitive behavioral therapy for insomnia and PAP for obstructive sleep apnea and comorbid insomnia: effects on nocturnal sleep and daytime performance.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Trial
- Loneliness is correlated with cancer mortality in US counties: an ecological analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Beyond respiratory control in COMISA: Towards precision phenotyping in PAP-based therapies.Sleep medicine reviews · 2026Article
- The promise and peril of data-driven approaches: interpreting the association of insomnia, sleep apnea, and COMISA with mortality in US veterans.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- The Hidden Burden of COMISA: Clinical Implications and Treatment Challenges.Pulmonary therapy · 2026Review
- Management of Adult Obstructive Sleep Apnoea: Many Questions, Not Enough Answers!Journal of sleep research · 2025Review
- Digital and AI-Enhanced Cognitive Behavioral Therapy for Insomnia: Neurocognitive Mechanisms and Clinical Outcomes.Journal of clinical medicine · 2025Review
- Determinants of treatment response to cognitive behavioral therapy in veterans presenting with comorbid insomnia and sleep apnea.Sleep & breathing = Schlaf & Atmung · 2025Article
- Sleep Deficiency in Obstructive Sleep Apnea.Sleep medicine clinics · 2024Review
- Research progress on the clinical subtyping of obstructive sleep apnea hypopnea syndrome.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Review
- An empirical comparison of sleep-specific versus generic quality of life instruments among Australians with sleep disorders.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Effect of melatonin on insomnia and daytime sleepiness, in patients with obstructive sleep apnea and insomnia (COMISA): A randomized double-blinded placebo-controlled trial.Journal of pharmaceutical health care and sciences · 2024Article
- Article
- Positive Airway Pressure Therapy Compliance in Patients With Comorbid Insomnia and Sleep Apnea.Clinical and experimental otorhinolaryngology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
STUDY
objectivesCognitive behavioral therapy for insomnia (CBTI) for comorbid insomnia and obstructive sleep apnea (OSA) has had mixed results. We integrated CBTI with a positive airway pressure (PAP) adherence program and tested effects on sleep and PAP use.
methods125 veterans (mean age 63.2, 96% men, 39% non-Hispanic white, 26% black/African American, 18% Hispanic/Latino) with comorbid insomnia and newly-diagnosed OSA (apnea-hypopnea index ≥ 15) were randomized to 5-weekly sessions integrating CBTI with a PAP adherence program provided by a "sleep coach" (with behavioral sleep medicine supervision), or 5-weekly sleep education control sessions. Participants and assessment staff were blinded to group assignment. Outcomes (baseline, 3 and 6 months) included Pittsburgh Sleep Quality Index (PSQI), 7-day sleep diary (sleep onset latency [SOL-D], wake after sleep onset [WASO-D], sleep efficiency [SE-D]), 7-day actigraphy (SE-A), and objective PAP use (hours/night and nights ≥ 4 h). Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10) were also collected.
resultsCompared to controls, intervention participants showed greater improvement (baseline to 3 and 6 months, respectively) in PSQI (-3.2 and -1.7), SOL-D (-16.2 and -15.5 minutes), SE-D (10.5% and 8.5%), SE-A (4.4% and 2.6%) and more 90-day PAP use (1.3 and 0.9 more hours/night, 17.4 and 11.3 more nights PAP ≥ 4 h). 90-day PAP use at 3 months was 3.2 and 1.9 h/night in intervention versus controls. Intervention participants also had greater improvements in ISI, ESS, and FOSQ-10 (all p < 0.05).
conclusionsAn intervention integrating CBTI with a PAP adherence program delivered by a supervised sleep coach improved sleep and PAP use in adults with comorbid insomnia and OSA.
trial registrationClinicalTrials.govStudy name: Novel Treatment of Comorbid Insomnia and Sleep Apnea in Older VeteransURL: https://clinicaltrials.gov/ct2/results?cond=&term=NCT02027558&cntry=&state=&city=&dist=Registration: NCT02027558.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.