0390 ASV Vs CPAP RCT: Changes in Anxiety And Depression in Complex Insomnia Disorder

Abstract

Introduction: Anxiety and depression are common among chronic insomniacs and associated with difficulties initiating/maintaining sleep. In a related abstract (?Changes in ISI?), PAP therapy reduced or eliminated complex insomnia (co‐occurrence of a chronic insomnia disorder and sleep apnea) symptoms with ASV proving superior to CPAP. We hypothesized PAP therapy would improve both anxiety and depression with large effects. Methods: A 15‐week, prospective, single‐blind (patients) RCT was conducted to study treatment with ASV(n=19) vs CPAP(n=21) (ResMed AirCurveTM) in chronic insomniacs without prior awareness of potential sleep apnea. Hopkins Symptom Checklist (HSCL) tracked anxiety (HSCL‐A) and depression (HSCL‐D) at baseline and two week intervals for study duration; baseline and final scores were compared. During the protocol, 19 patients were on psychotropic medication [sedatives (n=12), antidepressants (n=11), or anxiolytics (n=8)] and 21 were not. No sleep or psychotropic medications were introduced during study protocol. Results: Average intake HSCL‐A and HSCL‐D were in the very mild to mild range without significant differences between PAP groups. At final follow‐up, HSCL‐A and HSCL‐D scores had decreased by >;50% [HSCL‐A= ‐0.37(0.34), g=1.00; and HSCL‐D= ‐0.54(0.46), g=1.01, respectively; all p‐values