0534 How objective sleep quality with Odds Ratio Product differs by diagnosis of COMISA, OSA, and insomnia

Abstract

Abstract Introduction Recent research has highlighted differences in sleep quality for comorbid insomnia and obstructive sleep apnea (COMISA). We investigated how COMISA affects objective sleep quality measured with odds ratio product (ORP) compared to individuals without insomnia or moderate to severe OSA. Methods 410 participants (age 46.4±12.3; 174 females) recorded their sleep with in-home PSG using the Cerebra Sleep System and completed questionnaires. Sleep quality was measured using ORP derived from micro-analyzing frontal EEG channels. On the questionnaires, participants reported whether they experienced insomnia symptoms at least three times a week. Participants were classified as having no diagnosis if their RDI on the home PSG was < 15 and no insomnia symptoms. They were classified as insomnia only if they reported at least one insomnia symptom with an RDI < 15. They were classified as OSA only if they had an RDI ≥15 and reported no insomnia symptoms. Finally, they were classified as COMISA if they had an RDI ≥15 and reported at least one insomnia symptom. All analyses controlled for age and were corrected for multiple comparisons. Results 113(27.6%) patients were classified as having no diagnosis, 109(26.6%) as insomnia only, 83(20.2%) as OSA only, and 105(25.6%) as COMISA. There was a significant effect of diagnosis on ORPNREM (F3,405= 6.042, p<.001) and ORPTRT (F3,405= 3.799, p= 0.010). Participants with no diagnosis had lower ORPNREM than patients with OSA only (p= 0.039) and patients with COMISA (p<.001) and had lower ORPTRT than COMISA (p= 0.009). OSA severity based on the AHI was the only significant predictor of ORPNREM (p <.001, β= 0.321). Both AHI (p <.001, β=0.176) and number of insomnia symptoms (p=0.002, β=0.141) were significant predictors of ORPTRT. Conclusion Participants with no diagnosis had the lowest ORP indicative of better sleep quality than participants with evidence of sleep disorders. Having COMISA may have greater impacts on sleep quality than insomnia symptoms alone. OSA severity was the only predictor of poor sleep quality when looking at ORPNREM. Yet both OSA severity and insomnia symptoms were associated with higher ORPTRT indicating that individuals with COMISA may show alterations of sleep quality in different states throughout the night. Support (if any)