已完成的两年期资助项目取得了重要学术成就，发表SCI收录期刊论文16篇，现申请4年期延续资助。成年人中慢性失眠（CI）与阻塞性睡眠呼吸暂停（OSA）共病可能超过25%，CI与OSA均是引起心脑血管疾病的高风险因素。我们发现，基于多次睡眠潜伏期测量（MSLT）反映的生理性警觉水平增高是导致CI合并高血压的重要因素。CI患者的血浆ACTH和皮质醇水平增高可能是高觉醒的神经内分泌病理学因素，而OSA的间隙性低氧所致的交感神经和儿茶酚胺系统活动增强可能参与了心脑血管疾病的形成。推测，在CI和OSA共病患者中存在皮质醇和交感儿茶酚胺两个系统的过度增强，进一步增加心脑血管疾病的风险。本研究将对单纯失眠、失眠+OSA、单纯OSA及OSA+嗜睡病人，测量MSLT、血中ACTH和皮质醇、交感神经活性及尿中儿茶酚胺水平，以增加对CI和OSA共病患者中导致重大躯体疾病病理因素的了解，为治疗决策提供依据。

We achieved the significant scientific success in the previous two-years-funded research project. Under the support of this project, we published 16 papers in SCI cited scientific journals. We now apply for a four-years extension of new research proposal. In adults, the prevalence of patients with comorbid disorders of chronic Insomnia (CI) and obstructive sleep apnea (OSA) may be over 25%. Both CI and OSA are significantly high risk factors leading to cardiovascular and cerebrovascular diseases. We found that an increased physiological arousal reflected by an increased score on multiple sleepiness latency test (MSLT) is associated with increased risk of hypertension among CI patients. The increased level of ACTH and cortisol in blood appears to be the neuroendocrine pathological factor resulted in hyperarousal in CI patients, whereas the increased activities of sympathetic nerve and catecholamine led by OSA events related intermittent hypoxia may play important roles in the formation of cardiovascular and cerebrovascular diseases in OSA patients. We speculate that coexistences of increased cortisol level and sympathetic catecholamine activity may further increase the risk of cardiovascular and cerebrovascular diseases in patients with comorbid disorders of CI and OSA. In the current proposal, we plan to examine MSLT, ACTH and cortisol level in blood, muscle sympathetic nerve activity and catecholamine level in urine, in four different types of patients, including CI alone, CI+OSA, OSA alone and OSA+Excessive Sleepiness. The study is to explore the pathological factors leading to major somatic diseases in CI and OSA patients, in order to provide new data for the consideration of the treatment strategy in patients with comorbid disorders of CI and OSA.