SLEEP 2011 Abstract Supplement

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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 <strong>SLEEP</strong> 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 <strong>SLEEP</strong> 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
B. Clinical Sleep Science III. Sleep Disorders – Insomnia codes. Visits where at least one of 3 possible diagnoses was Insomnia (ICD9-CM code 780.52) were studied. Results: There were an estimated 31,038,892(±SE)(±2,004,876)patient visits(unweighted count=1512) with the diagnosis of Insomnia (ICD9- CM code 780.52): 63.4%(±2.1%)female and 36.6%(±2.1%)male; 82.3%(±2.4%)’white’,10.7%(±1.8%)’black’; mean± age:42.48±0.20 years. The odds ratio(OR) for Insomnia diagnosis from 2001-2006 versus 1995-2000 was 1.34(95%CI 1.08-1.67), with the greatest increase among the
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JOURNAL OF SLEEP AND SLEEP DISORDER
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EDITORIAL In June of 1986, roughly
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