Observational studyJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2026
Diabetes mellitus is associated with increased prevalence and severity of COMISA: evidence from the nationwide TURKAPNE cohort.
Observational study in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02784977 (TURKAPNE - The Turkish Sleep Apnea Database), which is not on this map. Cited by 2 papers.
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.
TURKAPNE - The Turkish Sleep Apnea Database: A National, Multicenter, Observational, Prospective Cohort Study
Who cites it
2 citing papers in PubMed.
- Reply to "Clarifying COMISA in diabetes: distinguishing true insomnia comorbidity from OSA-related sleep disruption".Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Clarifying COMISA in diabetes: distinguishing true insomnia comorbidity from OSA-related sleep disruption.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComorbid insomnia and obstructive sleep apnea (COMISA) is increasingly recognized as a clinically important sleep disorder phenotype with potential cardiometabolic consequences. However, its association with diabetes mellitus (DM) remains insufficiently characterized.
methodsThis cross-sectional analysis included 12,715 adults with suspected obstructive sleep apnea (OSA) from the nationwide multicenter TURKAPNE cohort who underwent full-night polysomnography. Insomnia symptoms were assessed using standardized questionnaire items, and OSA was defined as apnea-hypopnea index (AHI) ≥ 5 events/hour. COMISA was defined as the coexistence of insomnia symptoms and OSA. DM was identified based on self-reported physician diagnosis or use of antidiabetic medications. Multivariable logistic regression was performed to evaluate independent variables associated with COMISA.
resultsCOMISA was present in 3,275 patients (25.7%). DM was significantly more prevalent among patients with COMISA compared with those without COMISA (22.8% vs. 15.4%, p < 0.001). Overall, COMISA was observed in 33.9% of diabetic individuals and 24.1% of non-diabetic individuals. In multivariable analysis adjusted for age, sex, body-mass-index, smoking status, education level, and comorbidities, DM remained independently associated with COMISA (adjusted OR 1.17; 95% CI 1.05-1.31; p = 0.006). Among COMISA patients, those with DM exhibited greater sleep fragmentation and more severe sleep-disordered breathing, including higher AHI (30.0 vs. 24.0 events/h) and oxygen desaturation index (26.0 vs. 20.0 events/h) (p < 0.001).
conclusionsDM is independently associated with COMISA and with more severe sleep and respiratory disturbances within this phenotype. These findings highlight the need for integrated screening of sleep disorders in individuals with DM.
trial registrationClinicalTrials gov (NCT02784977).
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.