Relação da insônia comórbida e apneia obstrutiva do sono (COMISA) no desenvolvimento e no controle do diabetes tipo 2

Abstract

Introduction: Type 2 diabetes is one of the most common chronic diseases in Brazil and worldwide, being a major cause of morbidity. When not adequately controlled, it can significantly compromise the quality of life of these individuals. Although insomnia and obstructive sleep apnea are associated with type 2 diabetes, little is known about the concomitant presence of comorbid insomnia and sleep apnea (COMISA), characterized by the simultaneous presence of insomnia and obstructive sleep apnea. Synthesizing the scientific literature on COMISA in people with diabetes mellitus and understanding the population's interest in the subject may provide evidence of this relationship and highlight important gaps in studies for the advancement of the topic. Objective: To examine the state of the art and map the scientific production regarding the relationship between comorbid insomnia and sleep apnea (COMISA) in the development and control of diabetes mellitus, as well as to assess the interest of the Brazilian population in the topic. Materials and Methods: This is an infodemiological analysis using relative search volume (RSV) data on the subject in Google, using the Google Trends platform, and a scoping review using the PRISMA ScR checklist, with electronic searches conducted in the PubMed, Web of Science, Scopus, Embase databases and in grey literature (Google Scholar and Opengrey). The results were synthesized descriptively, using tables, with frequency analysis and in narrative format. Results: Over the last 20 years, a higher volume of searches for "Type 2 Diabetes" was observed. The term "Insomnia" showed the greatest growth trend, peaking in April 2020 (RSV 89). The average search volumes were 49.6 ± 22.4 for “Type 2 Diabetes”, 40.6 ± 19.1 for “Insomnia”, and 27.9 ± 17.4 for “Sleep Apnea”. Furthermore, a strong positive correlation was observed between search volumes for “Insomnia” and “Sleep Apnea” (r = 0.771), as well as between “Sleep Apnea” and “Type 2 Diabetes” (r = 0.771). The correlation between “Insomnia” and “Type 2 Diabetes” was considered moderate (r = 0.691). In the scoping review, 357 studies were identified, of which only nine met the inclusion criteria after full-text reading. Most studies had a cross-sectional design and were conducted between 2012 and 2024. Conclusion: Infodemiological analysis revealed growing public interest in the terms studied. Scoping review indicated that, although there is no strong correlation between COMISA and type 2 diabetes, the condition exacerbates chronic diseases, being associated with poorer glycemic control, higher cardiovascular risk, depressive symptoms, increased mortality, and reduced quality of life.