SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science III. Sleep Disorders – Insomnia
Results: Mean FIRST scores did not differ across genotype groups
(S’/S’, S’/L’, L’L’) (F2,246=0.5, p=0.6), nor did the genotype distribution
or allelic frequencies differ between “high FIRST” vs. “low
FIRST” groups (defined by median-split). Male carriers of 1-2 copies
of L (long allele, LG and/or LA) had significantly higher FIRST scores
than males with two copies of S (S/S: 17.0±6.0 vs. S/L&L/L: 19.2±5.4,
t=2.1, df=122, p=0.04). We observed a similar trend using the L’S’ model:
(S’/S’: 17.4±6.0 vs. S’/L’&L’/L’: 18.4±5.6, t=1.9, df=122, p=0.05).
Males with at least one L’ allele were over-represented in the “high
FIRST” group and carriers of two S’ alleles were under-represented in
the “low FIRST” group (χ2=4.5, df=1, p=0.03).
Conclusion: These data show an association between higher expressing
5-HTTLPR allele and risk for stress-related sleep disturbance in male
first-year students. These findings add evidence to the model of an association
between the serotonin transporter expression level and the spectrum
of stress-related disorders, the direction of the link being mediated
by sex among other factors.
Support (If Any): This work was supported by the National Institute
for Mental Health (grant R01 MH079179-01A2). Tifenn Raffray is supported
by the European Sleep Center, Paris France and l’Institut Servier,
Neuilly-sur-Seine, France.
0562
PATTERNS OF INSOMNIA IN OBSTRUCTIVE SLEEP APNEA
PATIENTS WHO ARE ADHERENT TO CPAP
Glidewell RN 1 , Roby E 1 , Orr W 1,2
1
Sleep Research, Lynn Institute for Healthcare Research, Colorado
Springs, CO, USA, 2 Research, Lynn Institute for Healthcare Research,
Oklahoma City, OK, USA
Introduction: Insomnia frequently co-occurs with Obstructive Sleep
Apnea (OSA) and there is evidence that insomnia persists despite effective
treatment of OSA. In order to separate insomnia symptoms due to
OSA from independent insomnia symptoms, we examined the patterns
of insomnia in OSA patients adherent to CPAP.
Methods: We analyzed Insomnia Severity Index (ISI) item scores in
35 OSA patients who used CPAP therapy ≥ 4 hours per night during the
first 30 days of treatment (Average use 384±78.6 minutes). The ISI was
completed prior to initiation of CPAP and an average of 43±6.6 days
post CPAP initiation. ISI items are scored on a 0-4 scale with scores of ≤
1 representing none/mild symptoms and scores of ≥2 representing moderate
to very severe symptoms. Patients were classified into one of two
insomnia symptom patterns, which were defined as: RESPONDERS (≥
moderate pretreatment symptoms and none/mild follow-up symptoms)
and PERSISTERS (≥ moderate symptoms at both time points).
Results: 51.4% (N=18) of patients were classified as responders and
48.6% (N=17) as persisters. Compared to the persisters, responders
experienced greater reductions in insomnia symptoms following treatment
(total insomnia score reductions of 4.2 vs. 1.9; t=2.7, p = .012). At
follow-up, responders had significantly lower scores than persisters for
falling asleep (0.33 vs. 1.41, t=-4.6, p < .001), staying asleep (0.56 vs.
1.82; t=-5.2, p < .001), waking too early (0.56 vs. 1.65; t=-4.3, p < .001),
and the insomnia subscale (1.4 vs. 4.9; t=-6.6, p < .001).
Conclusion: 1) Treatment of OSA with CPAP is clearly associated with
marked reduction of insomnia symptoms for over half of symptomatic
patients. 2) These data confirm that a substantial proportion of OSA
patients have persistent insomnia symptoms which may require further
targeted treatment.
0563
INSOMNIA AMONG SLEEP APNEA PATIENTS AND
CONTROLS
Björnsdóttir E 1 , Benediktsdottir B 2,1 , Janson C 3 , Sigurdsson JF 4,1 ,
Pack A 5 , Gislason T 2,1
1
Faculty of Medicine, University of Iceland, Reykjavík, Iceland,
2
Department of Respiratory Medicine and Sleep, Landspítali University
hospital, Reykjavík, Sweden, 3 Department of Medical Sciences:
Respiratory Medicine and Allergology, Uppsala University, Uppsala,
Sweden, 4 Department of psychiatry, Landspitali University hospital,
Reykjavík, Iceland, 5 Center for Sleep and Respiratory Neurobiology
and Division of Sleep Medicine/Department of Medicine, University of
Pennsylvania School of Medicine, Philadelphia, PA, USA
Introduction: Insomnia and obstructive sleep apnea (OSA) often coexist,
but the nature of their relationship is unclear. The aim of this study
was to compare the prevalence of initial and middle insomnia between
OSA patients and controls with and without OSA symptoms.
Methods: Two groups were compared in this study, OSA patients
(n=824) and a control group of individuals, 40 years and older from the
general population in Iceland (n=724). The control group was subdivided
into individuals without (n=630) and with (n=88) OSA symptoms
(habitual snoring and witnessed apneas). The prevalence of insomnia
was evaluated in these groups and the relationship between OSA and
insomnia symptoms was examined. All subjects answered the same
questionnaires on health and sleep and OSA patients underwent a sleep
study. Altogether, 53% of controls were males compared to 80% of OSA
patients. The mean age among controls was 54.4 and 56.3 among OSA
patients.
Results: The majority of OSA patients (57.6%) reported difficulties
maintaining sleep (DMS) compared to 32% of controls (p