PHARMACIES CAN HELP PATIENTS BETTER UNDERSTAND THEIR SLEEP DIFFICULTIES AND SUPPORT THEM
Behavioral Therapy for insomnia (CBTi) further contribute to its under-recognition.
Introducing the AWAKE Study: A New Approach to Screening The AWAKE study is a UK wide initiative led by an international research team that aims to shine a spotlight on this hidden epidemic. Using innovative community-based screening, the study will invite adults to take part in a short five- minute online survey delivered via mobile phone.
The AWAKE Check study uses validated instruments, the STOP-Bang questionnaire for OSA and the Insomnia Severity Index (ISI) for insomnia to provide accurate insights.
By engaging people through community pharmacies, social media and news outlets, the study aims to reach 5,000 UK adults and assess their risk for sleep disorders.
This approach offers: • Composite risk scoring that integrates OSA and insomnia indicators.
• Tailored feedback based on individual risk profiles.
• Geographic mapping to highlight sleep disorder prevalence across the UK.
Why This Matters COMISA is more than a sleep issue - it’s a public health concern. Untreated COMISA is linked to: • Cardiovascular and metabolic diseases • Mental health disorders • Reduced work productivity • Increased healthcare costs
By identifying at-risk individuals early, the AWAKE study hopes to empower patients, inform clinicians, and influence policy toward better sleep health strategies.
The Role of Community Pharmacy Community pharmacists are in a unique position to support the identification and management of COMISA. Patients may not seek medical help for sleep problems, but they often present in pharmacies with fatigue, repeated requests for over-the-counter sleep aids, or concerns about daytime drowsiness. These encounters are opportunities to open a conversation.
Pharmacists can ask simple screening questions about sleep quality; encourage patients to complete the AWAKE Check survey by scanning a QR code in the pharmacy and provide practical advice on good sleep hygiene and the importance of further assessment if COMISA is suspected. By taking these steps, pharmacies can help patients better understand their sleep difficulties and support them in seeking appropriate medical advice.
Consider the case of a patient in their mid-50s who has been purchasing over the counter sleep remedies regularly from your pharmacy. Despite trying several products, their sleep difficulties continued. On gentle questioning, they admit to loud snoring and daytime sleepiness. A referral eventually leads to a diagnosis of COMISA. With treatment, both their insomnia and apnoea can improve, leading to better overall health and quality of life. Cases like this illustrate why COMISA should not be overlooked and how pharmacy teams can play a vital role in identifying those at risk.
Looking Ahead The findings from the AWAKE study could provide vital insights into the prevalence of COMISA in the UK and inform future healthcare strategies. For community pharmacy, this may open up new opportunities for involvement in sleep health — from screening initiatives to public awareness campaigns and patient support services.
Final Thoughts Sleep disorders like COMISA are complex to manage, but they are not insurmountable. With tools like the AWAKE Check and a commitment to community engagement, we can begin to unravel the burden of co-morbid insomnia and sleep apnoea.
References 1. Solelhac, G., et al., Prevalence and clinical significance of Comorbid Insomnia and Sleep Apnea (COMISA) in three population-based cohorts from Benin, Switzerland and India. Sleep medicine, 2025: p. 106526. 2. weetman, A., L. Lack, and C. Bastien, Co-morbid insomnia and sleep apnea (COMISA): prevalence, consequences, methodological considerations, and recent randomized controlled trials. Brain Sciences, 2019. 9(12): p. 371. 3. Sweetman, A., et al., Bi-directional relationships between co- morbid insomnia and sleep apnea (COMISA). Sleep Med Rev, 2021. 60: p. 101519. 4. Benjafield, A.V., et al., Estimation of the global prevalence and burden of insomnia: a systematic literature review-based analysis. Sleep Medicine Reviews, 2025. 82: p. 102121. 5 Sweetman, A., et al., Bi-directional relationships between co- morbid insomnia and sleep apnea (COMISA). Sleep Medicine Reviews, 2021. 60: p. 101519. 6 Wu, M., et al., Association between age and comorbid insomnia and sleep apnea. Sleep Medicine, 2024. 124: p. 659-661.
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