0604 Depression, Anxiety and Coping-avoidance Behaviors Associated with Long-Term Insomnia Symptoms During the COVID-19 Pandemic

Abstract

Abstract Introduction Stressful events, such as the COVID-19 pandemic, can have long-lasting, detrimental effect on sleep. It is important for practitioners to understand how their patients may be stil experiencing residual negative effects of the pandemic to optimize their care. In this study we evaluated how measures of self-reported measures of anxiety and depression during the COVID-19 pandemic predicted measures of sleep disturbnce 6 months later among sleep medicine clinic patients. Methods Between June-November 2020, 81 sleep medicine clinic patients (54.8±15.9 y, 44% male, 69% Caucasian) completed an online survey that included PROMIS measures (Sleep Disturbance, Sleep-Related Impairments, Informational Support, Emotional Distress-Anxiety) and Insomnia Severity Index (ISI). Patients were recontacted 6 months later to complete the same surveys. 54 patients (55.2±18.4 y, 39% male, 70% Caucasian) completed the follow-up survey and were included in this present analysis. We conducted multivariate regression analyses to determine how the change in self-reported PROMIS measures from baseline during the pandemic were predictive of post-pandemc 6 month follow-up PROMIS measures and ISI. Results PROMIS depression score at baseline was predictive of both sleep disturbance (0.63 ± 0.15; p<.0001) and sleep impairment (0.49 ± 0.18; p=0.01) 6 months later. Baseline brief coping avoidance also predicted 6 month sleep disturbance (0.85 ± 0.33; p<0.009) and sleep impairment (0.85 ± 0.33; p=0.014) as well as ISI (0.52 ± 0.18 units; p=0.006). Baseline anxiety predicted ISI at 6 months (0.25 ± 0.09 units, p=0.009). Conclusion Higher levels of self-reported depression, anxiety and coping-avoidance behaviors during the COVID-19 pandemic lead to long-lasting increase in sleep disturbance and impairment as well as insomnia. Addressing depression, anxiety and coping behaviors that occur as result as a stressful event is advised to avoid long-term detrimental effects on sleep. Support (If Any) This work is supported by National Institutes of Health (NIH) Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413).