0446 Sleep Disordered Breathing Treatment is Associated with Improved Mental Health Symptoms and Quality of Life in Women Veterans

Abstract

Abstract Introduction Sleep disordered breathing (SDB) is associated with poor mental health and lower overall quality of life (QOL); however, research examining these outcomes after positive airway pressure (PAP) therapy for SDB in women is limited. We studied a 6-session PAP adherence program that included behavioral sleep improvement strategies plus concepts of Acceptance and Commitment Therapy (ACT) to promote sustained PAP use, and evaluated the impact of this ACT-based program on daytime and mental health symptoms and quality of life in a sample of women veterans with SDB who were prescribed PAP. Methods Women veterans with SDB (n=90, mean = 53.2 years [range 26-80]) receiving care in an urban VA healthcare system were randomly assigned to a “control” SDB/PAP education program or the “Acceptance and Behavioral Changes to treat Sleep Apnea” (ABC-SA) program. All received PAP therapy. Measures included: Epworth Sleepiness Scale (ESS), Flinders Fatigue Scale (FFS), Patient-Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder Questionnaire 7-item (GAD), and The World Health Organization Quality of Life Scale, Brief (WHOQOL BREF). Mixed-effect models assessed the main effect of time across groups and between-group changes in these measures at post-treatment and 3 month-follow up compared to baseline. Results For the main effect of time, participants in both groups had significant improvements at post-treatment and 3-month follow-up in sleepiness, fatigue, depression, anxiety, and QOL (all p< 0.05). Compared to controls, women who received ABC-SA reported greater improvements in daytime sleepiness (ESS) at post treatment (p=0.04) and in fatigue (FFS) at 3-month follow-up (p=0.008). Conclusion PAP treatment in women with SDB was associated with improvements in measures of mental health and QOL. There was some evidence of even greater benefits with ABC-SA. Further work is needed to understand the relationship between SDB treatment and improved mental health outcomes in women and other underrepresented populations. Support (if any) VA HSR&D IIR 16-244 and RCS 20-191; NIH/NHLBI K24 HL143055, HRS&D COIN; VAGLAHS GRECC and VA Office of Academic Affiliations