From time to time I enjoy writing letters to the editor of sleep medical or other journals on topics I perceive as poorly covered. My letter was just published in response to a researcher who had written her own letter to the same Journal of Clinical Sleep Medicine.
The gist of her group’s concern/complaint is how difficult it is to find “clean” insomniacs who show very few co-occurring medical or psychiatric conditions. These conditions make things more difficult to evaluate in the treatment of the insomnia when the other condition might be influencing therapy.
My criticism of Medalie and colleagues letter was the absence of any real discussion on how commonly sleep-disordered breathing occurs with insomnia and how much impact SDB has on sleep fragmentation, a common finding among insomniacs. In other words, sleep breathing problems are the reason there are so few “clean” insomniacs.
When researchers, doctors, or therapists overlook this co-occurrence, they do a disservice to patients who may wait years working on the psychological aspects of insomnia before undergoing a sleep study. This study would prove physiological factors are also driving the insomnia (sleep fragmentation).