How Do I Find Out if I Have Sleep Apnea and Insomnia Combined?

Why Is Insomnia and Sleep Apnea Combined Underdiagnosed?

Insomnia and obstructive sleep apnea (OSA) are common sleep disorders, but they can also occur together. This combination is known as comorbid insomnia and sleep apnea, or COMISA, and research suggests that 30 to 50% of people with OSA experience insomnia symptoms, while 30 to 40% of people with insomnia meet diagnostic criteria for OSA.¹ Although despite this overlap, COMISA can easily go unrecognised.

The symptoms can look very similar

One of the biggest challenges is that insomnia and OSA share several symptoms. Both can cause frequent waking, poor-quality sleep, daytime fatigue and difficulty functioning during the day. This makes it easy for symptoms to be attributed to whichever condition is identified first.

For example, someone diagnosed with OSA might also have persistent difficulty falling asleep. This may be assumed to be part of their OSA rather than recognised as a separate insomnia disorder requiring its own treatment.

They are diagnosed in different ways

Another challenge is that insomnia and OSA often follow different assessment pathways. OSA is usually investigated through a sleep study. Insomnia, however, is generally assessed through a conversation about sleep patterns, symptoms and daily functioning.

This means the condition that brings someone to their doctor may shape what happens next. Someone seeking help because they cannot fall asleep may be assessed for insomnia without undergoing a sleep study, potentially leaving underlying OSA undetected. Conversely, someone referred because of snoring or breathing pauses may undergo testing for OSA without their insomnia symptoms being fully explored.

Not everyone has the classic symptoms

OSA is often associated with obvious snoring, breathing pauses and daytime sleepiness, but not everyone presents this way. Men and women can also experience OSA differently.¹ Men more commonly report classic symptoms such as snoring and breathing pauses, while women may be more likely to report insomnia symptoms.¹ This can make underlying OSA easier to overlook.

Why recognising both conditions matters

Treating one condition does not necessarily resolve the other. Research has found that insomnia symptoms may persist even when the sleep apnea component of COMISA is treated.¹ Untreated insomnia may also make it more difficult to consistently use CPAP therapy.¹

The key is recognising that poor sleep may have more than one cause. If you regularly struggle to fall or stay asleep, particularly if you also experience snoring, breathing pauses, unrefreshing sleep or persistent daytime fatigue, speak with your doctor. Asking whether both insomnia and sleep apnea could be contributing to your symptoms may help you get a more complete assessment and the right treatment.

How Sove CPAP Clinic Can Help

When poor sleep could have more than one cause, getting a comprehensive assessment matters. At Sove CPAP Clinic, we look beyond a single symptom to help understand what may be contributing to your sleep difficulties. Our clinical team includes Sleep and Respiratory Physicians, alongside experienced Treatment Consultants, allowing us to assess your symptoms, sleep patterns and potential risk factors for conditions including insomnia and obstructive sleep apnea.

We offer bulk-billed home sleep studies to investigate for obstructive sleep apnea, and if sleep apnea isn’t the only issue – or insomnia symptoms continue alongside it – our team can help identify the next steps and develop a personalised treatment plan based on your individual sleep concerns.

Depending on your results and needs, this may include support for insomnia, CPAP therapy, mandibular advancement splints (MAS), or referral and ongoing care with our clinical team. With both face-to-face and telehealth consultations available, we can help you understand what’s really disrupting your sleep and find an appropriate pathway forward.

If you’re struggling with insomnia, snoring, waking unrefreshed, daytime fatigue or other ongoing sleep problems, call our friendly team on 1300 76 29 39 or email info@thecpapclinic.com.au to find out how Sove can help.

ALWAYS FOLLOW THE DIRECTIONS FOR USE. CPAP is used for Obstructive Sleep Apnea treatment. MAS is intended to assist in and or prevent snoring and/or obstructive sleep apnea. When considering whether a sleep study, MAS or CPAP is right for you, speak to your doctor. Medicare criteria and T&Cs apply.

References

1. Sleep Institute. “COMISA Diagnostic Challenges & Underdiagnosis | Sleep Institute.” Resmedsleepinstitute.Com, Resmed, 8 July 2025, https://www.resmedsleepinstitute.com/insights/comisa-diagnostic-challenges. Accessed 18 Aug. 2026.