The Impact of Comorbid Insomnia and Sleep Apnea (COMISA) on Work Ability: Results From Population-Based Panel Data in Korea

This study aimed to investigate the impact of comorbid insomnia and sleep apnea (COMISA) on work ability (WA) in the Korean workforce using data from a nationwide panel study. Data were derived from the Korean Work, Sleep, and Health Study (KWSHS), conducted from 2022 to 2024. Participants included 10,086 workers aged 19–70 years, with repeated measures collected across three survey waves. COMISA was defined using the Berlin Questionnaire for high-risk sleep apnea and the Insomnia Severity Index for clinical insomnia. WA was assessed using the Work Ability Index (WAI). Generalised estimating equation models analysed the association between COMISA and WA, adjusting for age, gender, and occupation. Subgroup analyses examined gender, age, and occupational variations. COMISA was strongly associated with reduced WA. Compared to the normal group, the odds ratio (OR) for poor WA in the high-risk for COMISA group was 5.742 (95% CI, 4.715–6.993) after adjusting for confounders. COMISA exhibited a more significant impact on individuals below 60 years, white-collar, and daytime workers. Mean WA scores in the COMISA group were 4.377 points lower (95% CI, 4.161–4.593) than in the normal group. Subgroup analyses revealed demographic-specific vulnerabilities, underscoring the compounded effects of COMISA. COMISA is significantly associated with poor WA, with pronounced effects among certain demographic groups. These findings suggest that targeted workplace interventions, integrated treatment strategies, and routine screening may help mitigate COMISA's potential impact on worker productivity and well-being.