Military Mother’s 20 Years of Misery with Comorbid Insomnia and Sleep Apnea (COMISA)


Annette is a mother of three, military spouse, and a pediatric occupational therapist. For more than 20 years, she has not felt rested.

After many, many years of not being able to sleep, she participated in her first sleep study approximately 15 years ago. When she presented to the sleep lab, the tech demonstrated surprise to see her and commented that it was unusual to see a patient with her body type for a sleep study. After the study she was given medication and no follow-up appointment. At the next overseas assignment, she participated in another sleep study due to continued difficulty falling and staying asleep. She received better follow-up care this time; she saw a Flight Medicine doctor who tried everything to help her identify the cause of her sleep problem. After a battery of tests, numerous trials of sleep medications and a few visits with a behavioral health provider to address stress factors, sleep did not consistently improve.

A few years later while in graduate school and still not feeling rested, she participated in her third sleep study. This time she was referred to a sleep specialist, who finally diagnosed her with Obstructive Sleep Apnea and prescribed a Continuous Positive Airway Pressure (CPAP) therapy machine. Annette used her CPAP religiously, but her sleep did not improve. Upon moving to Colorado Springs, one final sleep study was conducted solely for the purpose of adjusting her CPAP settings.

Throughout this time, Annette and her family moved multiple times, which made continuity of care an obstacle. Annette was prescribed medication for sleep, but she took it infrequently and only as a last resort. Despite her strong adherence to CPAP therapy, she never felt rested, had difficulty concentrating during the day, and found herself becoming more and more short-tempered with her family. She had stopped discussing her sleep problem with medical providers and had begun to believe that her sleep would never improve. She had little reason to believe that a medical provider would have any solutions for her that did not involve additional medication or adjustment of her CPAP settings. She felt helpless to fix her situation and was rapidly losing hope. Finally, her husband encouraged her to seek additional support. She met with a mental health provider through the military and says that she broke down almost as soon as she sat down for the appointment.

All the frustration, lack of control, and confusion about her situation came pouring out, and she was referred to The Insomnia Clinic for specialized treatment. Since completing the Sleep Recovery Program and learning about Comorbid Insomnia and Sleep Apnea (COMISA), she has gained tools that address her chronic insomnia, a problem that was previously only treated with unwanted and ineffective medication. Following cognitive-behavioral therapy for insomnia (CBT-I), her insomnia is now in remission.  Although she experienced moderate fatigue prior to working with The Insomnia Clinic, fatigue is no longer a problem and she now has more energy and motivation every day.  She says she is able to focus more effectively at work and be the mother and spouse she wants to be.

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