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Introduction: Insomnia and obstructive sleep apnoea (OSA) are the two most prevalent sleep disorders, and frequently co-occur (COMISA) in sleep clinic samples. However, few studies have investigated the prevalence or associations of COMISA in the general population.Methods: We used population-based online survey data from 2044 Australian adults. The prevalence and associations of insomnia, OSA and COMISA were investigated according to symptom-level, and disorder-level definitions. Insomnia was defined according to chronic difficulties initiating and/or maintaining sleep (DIMS; symptom-level), and ICSD-3 chronic insomnia disorder (disorder-level). OSA was defined according to self-reported frequent obstructive events, snoring or doctor-diagnosed OSA (symptom-level), and doctor-diagnosed OSA (disorder-level). COMISA was defined if both conditions were met (for symptom-level, and disorder-level threshold). Associations with other conditions, and general health were investigated with Poisson regression analyses.Results: Chronic insomnia occurred more frequently among participants with doctor-diagnosed OSA (22.3%), compared to those without (14.3%, p = 0.010). Doctor-diagnosed OSA was more common among participants with chronic insomnia (10.2%) compared to those without (6.2%; p = 0.010). DIMS also occurred more frequently among participants with OSA symptoms (66.6%), compared to those without (47.2%; p < 0.001). Participants with symptom-level COMISA reported increased co-morbid conditions, and worse general health compared to participants with symptoms of insomnia-alone, OSA-alone, or neither insomnia/OSA.Conclusions: COMISA at symptom and disorder level were common and associated with increased medical and psychiatric co-morbidity, as well as poor general health. More investigation is required to understand bi-directional associations underpinning the high co-morbidity, and improve diagnostic and treatment approaches for COMISA to reduce associated morbidity. [ABSTRACT FROM AUTHOR]

Social jetlag is a term used to describe misalignment between biological and social time. Measured as the difference in sleep midpoints between work and free days, social jetlag has been associated with unhealthy lifestyle behaviours and adverse health outcomes. This study aimed to identify the prevalence of social jetlag, and its sociodemographic and behavioural correlates in 837 respondents who completed the Sleep Health Foundation Australia 2016 online survey. Binomial logistic regression models determined associations between social jetlag and self-reported lifestyle and work outcomes, excluding night, evening or rotating shift workers. One third (31.1%) of respondents experienced >1h of social jetlag. In analyses adjusted for sociodemographic variables associated with social jetlag (age, marital status, work status and metropolitan living plus the significant interaction term for age by metro living), social jetlag was associated with longer sleep duration on free days (OR = 2.8, CI = 1.9-4.1), evening preference (OR = 2.0, CI = 1.4-2.4), often staying up later than planned on work days (OR 1.9, CI = 1.3-2.9), and having a computer (OR = 1.7, CI = 1.2-2.4) or phone (OR = 1.6, CI = 1.1-2.4) in the bedroom and internet use in the hour before bed (OR = 1.7, CI 1.2-2.5). Almost twice as many working respondents with social jetlag reported going to work when they should have taken sick leave due to their state of health (OR = 1.9, CI = 1.3-3.0). In conclusion, social jetlag is prevalent in the Australian community and associated with bedtime technology use. Work attendance when in poor health is cause for concern in Australian day workers and requires further investigation. [ABSTRACT FROM AUTHOR]

Background: The combination of shift work and an unmanaged sleep disorder carries health and safety risks. Yet, diagnosis rates for sleep disorders are low in shift workers. The aim of this study was to understand the experience of sleep disorder diagnosis and treatment in shift workers, and consider patient informed solutions to improve access to health services., Methods: Semi-structured interviews were conducted with 16 Australian shift workers with a diagnosed sleep disorder. Patient journey mapping and reflexive thematic analysis were used to understand diagnosis and management experiences., Results: There were highly variable experiences with diagnosis and management, often taking >5 years to seek help from a health care provider (HCP) after noticing symptoms of a sleep disorder. Three themes were constructed, including 'the cause of the problem', 'prioritising work', and '(dis)satisfaction and (dis)connection'. Extent of patient and HCP awareness of sleep disorders, and a prevailing attitude of shift work being 'the problem' impacted diagnosis, as did organisational needs (including rostering, which had both positive and negative influences on help seeking). Relationships with HCPs were important, and living on non-standard time was both a barrier and an enabler to sleep disorder care. Participants identified the need for education and awareness, prompts and easy access to screening and referral pathways, and tailored models of care., Conclusion: Education and awareness initiatives for shift workers, their employers and HCPs, together with development of a model of care for shift workers with sleep disorders may address some of the unique barriers to diagnosis and management., Competing Interests: Declaration of competing interest ACR reports research funding from the Lifetime Support Authority, Sydney Trains, Flinders Foundation, Hospital Research Foundation, Medical Research Future Fund, Vanda Pharmaceuticals, Safework SA, research consulting fees from Compumedics, and honoraria for presentation of education materials related to shift work from Teva Pharmaceuticals. RJA reports funding from the NHMRC, MRFF, ResMed Foundation, Hospital Research Foundation, Philips, Commonwealth of Australia and Sydney Trains, and equipment support from Neuroflex. For both authors, this support was outside the scope of the present manuscript., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)