A study found that men with sleep apnea and insomnia have a higher prevalence and severity of depressive symptoms than men with sleep apnea or insomnia alone.

In the study of 700 men in the community, 43% of those with both conditions had depression, compared with 22% of those with insomnia alone and 8% of those with sleep apnea alone. The study also found that 6.7% of men in the community had undiagnosed sleep apnea in combination with insomnia. This is slightly higher than the prevalence of insomnia alone (5.3%).

“Primary carers need to recognize that insomnia and sleep apnea commonly occur together and are strongly associated with poor mental health outcomes,” says Carol Lang, PhD, lead author of the Respirology study, in a release. “Correct and efficient diagnosis of sleep apnea and insomnia will improve recognition of this comorbid disorder and may avoid potentially counter-productive hypnotic medication prescription in many men.”