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This prospective cohort study reveals that patients with obstructive sleep apnea (OSA) who also suffer from comorbid insomnia (COMISA) experience a more pronounced reduction in 24-hour systolic blood pressure (SBP) after four weeks of CPAP therapy compared to those with OSA alone. Insomnia symptoms independently predict achieving clinically meaningful blood pressure control, suggesting a distinct clinical phenotype with enhanced cardiovascular responsiveness to treatment.
