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What Happens If Comorbid Insomnia and Sleep Apnea Is Left Untreated?

September 28, 2026

What Happens If Comorbid Insomnia and Sleep Apnea (COMISA) Is Left Untreated?

Living with poor sleep night after night can affect much more than how tired you feel the next morning. When insomnia and obstructive sleep apnea (OSA) occur together, a condition known as comorbid insomnia and sleep apnea (COMISA), the effects of two sleep disorders can combine and have a significant impact on everyday life and long-term health.

Poor sleep can become an ongoing cycle

Insomnia can make it difficult to fall or stay asleep, while OSA repeatedly disrupts sleep when the airway narrows or closes. For someone with COMISA, this can mean struggling to get to sleep only to have that sleep repeatedly interrupted once it finally arrives.

Without appropriate treatment, this ongoing disruption can contribute to poor-quality sleep and persistent daytime fatigue. People with COMISA generally experience worse sleep and daytime functioning than those with either insomnia or OSA alone.1

Daytime functioning may suffer

The consequences can follow you throughout the day. COMISA is associated with sleepiness, fatigue and concentration difficulties, which can make work and everyday responsibilities more challenging.2 Research has also found greater cognitive impairment and poorer quality of life among people with COMISA compared with those who have only one of the two sleep disorders.1

Daytime sleepiness can also become a safety concern. Reduced alertness and slower reaction times associated with sleep disorders can increase the risk of errors and motor vehicle accidents.3

Your physical health may be affected

Leaving COMISA untreated may also have implications for long-term physical health. Research has linked COMISA with poorer cardiovascular health, including an increased likelihood of hypertension, stroke, and heart failure.4

Research has also investigated links between COMISA and cardiovascular events and mortality. While some studies have found increased risks, results have not been completely consistent, and researchers are continuing to investigate these associations.4

Treating only one condition may not be enough

COMISA can be particularly challenging because addressing one sleep disorder may leave the other untreated. Persistent insomnia can also make treatments for OSA more difficult to use consistently.2 Research increasingly supports an integrated approach that addresses both the insomnia and breathing-related aspects of COMISA.

When should you seek help?

Poor sleep does not have to become your normal. If you regularly struggle to fall or stay asleep and also experience snoring, breathing pauses, gasping, unrefreshing sleep or ongoing daytime fatigue, speak with your doctor. Identifying both conditions and treating them appropriately can help improve your sleep, daytime functioning and overall health.

How Sove CPAP Clinic Can Help

Poor sleep does not have to be something you simply learn to live with. When symptoms of insomnia and sleep apnea overlap, understanding whether one or both conditions are contributing to your sleep problems is an important first step.

At Sove CPAP Clinic, our team of Sleep and Respiratory Physicians and experienced Treatment Consultants can assess your symptoms, sleep patterns and potential signs of both insomnia and obstructive sleep apnea. We offer bulk-billed home sleep studies for eligible patients to investigate sleep apnea, while also considering ongoing difficulties falling asleep, staying asleep or returning to sleep.

If both conditions are contributing to your poor sleep, our team can help develop a personalised treatment pathway that addresses your individual needs rather than focusing on only one part of the problem. Depending on your assessment, this may include insomnia support, CPAP therapy, a mandibular advancement splint (MAS), or further care with our clinical team.

With face-to-face and telehealth consultations available, Sove can support you from assessment through to treatment and ongoing care. If poor sleep is affecting your energy, concentration, daytime functioning or overall wellbeing, 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. “General Practitioner Management of Comorbid Insomnia and Sleep Apnoea.” Australian Journal of General Practice, 2024, https://www1.racgp.org.au/ajgp/2023/september/general-practitioner-management-of-comorbid-insomn. Accessed 18 Aug. 2026.

2) Sweetman, Alexander, et al. “Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials.” Brain Sciences, vol. 9, no. 12, Dec. 2019, p. 371, https://doi.org/10.3390/brainsci9120371.

3. Sleep Health Foundation. “Co-Morbid Insomnia and Sleep Apnoea.” Sleephealthfoundation.Org.Au, Sleep Health Foundation, 19 Feb. 2025, https://www.sleephealthfoundation.org.au/sleep-disorders/co-morbid-insomnia-and-sleep-apnoea. Accessed 18 Aug. 2026.

4) Popovici, Cristian, et al. “The Hidden Burden of COMISA: Clinical Implications and Treatment Challenges.” Pulmonary Therapy, Nov. 2025, https://doi.org/10.1007/s41030-025-00331-0.