0486 Do Symptoms Of Sleepiness And Insomnia Vary By Age In US Veterans With Obstructive Sleep Apnea?

Abstract

Introduction: The influence of aging on the symptomatic presentation of obstructive sleep apnea (OSA) is not well-characterized in US veterans. Our aims were to 1) examine age and established predictors of sleepiness and insomnia symptoms in US veterans with OSA and 2) determine if the relationship between predictors and sleepiness and insomnia depended on age. Methods: We performed a retrospective analysis of US veterans newly-diagnosed with OSA at the Miami VA in 2015. On diagnostic PSG night (76% attended studies), questionnaires were completed querying demographics, social characteristics, insomnia symptoms (Insomnia severity index [ISI]), sleepiness (Epworth sleepiness scale [ESS]) and self-reported sleep duration. Medical and psychiatric comorbidities were assessed with electronic medical record review. Linear regression modeling was used to explore the association of variables with 1) ESS and 2) ISI. Regression analyses were performed in two steps: 1) all variables were entered simultaneously testing for main effects, 2) the product of age and each variable found to have an association at a significance level of p < 0.10 with the primary outcome was entered separately to test for interaction. Results: The sample consisted of 483 veterans (93% male, age 52 ± 13 yrs, 41% black, 34% Hispanic) diagnosed with OSA (AHI 36 ± 28 events/hr of sleep). Having a regular bed partner, higher weighted medical comorbidities, chronic pain diagnosis, and shorter sleep duration were associated with ESS. Age did not moderate the relationship between these variables and the ESS. Younger age, Hispanic ethnicity, higher educational level, shorter sleep duration, mood and pain diagnoses were each associated with the ISI. Furthermore, an age-sleep duration interaction term was associated with the ISI (b = -0.03; p=0.005). For all participants, there was an inverse relationship between sleep duration and ISI scores. However, for any sleep duration, older veterans reported a lower level of insomnia symptoms than younger veterans. Conclusion: Older veterans with OSA may report less sleep complaints. Personalized screening methods for older individuals with OSA may be needed.