Abstract

Determine the prevalence and effect of Obstructive Sleep Apnea (OSA) and Insomnia in patients with neurological disorders. Limited data exists on OSA and Insomnia prevalence in neurological disorders. Data was collected from 03/2015-10/2016 from five specialized Centers. High-risk OSA (HR-OSA) was defined as STOP≥2, and high-risk Insomnia (HR-Insomnia) as ISI≥15. We used the following health status scales to determine disease severity: Karnofsky Performance Scales (KPS) for Brain Tumors (BT), Modified Rankin Scale (mRankin) for Stroke and other neurological disabilities (CV), Unified Parkinson's Disease Rating Scale II (UPDRS-II) for Parkinson's and related movement disorders (MD), Liverpool Seizure Severity Scale 2.0 (LSSS) for Epilepsy (EPI), and Patient Health Questionnaire 9 (PHQ-9) for Psychology & Psychiatry (PSYC). Models were adjusted for pre-specified covariates. We included 6224 patients; mean age was 50.29 (18.36), and 58.69% were female. Sample constitution included: BT 11.6%, CV 16.5%, MD 23.3%, EPI 16.2%, and PSYC 32.4%. Overall, HR-OSA and HR-Insomnia were 36.5% (95%CI=35.3-37.7) and 24.6% (95%CI=23.6-25.7), with the highest HR-OSA in CV 48.1% (95%CI=45-51.2), and the highest HR-Insomnia in PSYC 33.6% (95% CI, 31.6-35.8). KPS score <60 was associated with higher HR-OSA (OR=2.67, 95%CI=1.3-6.4) and HR-Insomnia (OR=3.87, 95%CI=1.495-11.50). For each unit increase in UPDRS II score, odds of HR-OSA increased by 3.6% (OR=1.036, 95%CI=1.018-1.054), and HR-Insomnia increased by 9.7% (OR=1.097, 95%CI=1.061-1.134). mRankin >2 had higher odds of HR-OSA (OR=2.11, 95% CI=1.384-3.22) and HR-Insomnia (OR=3.9, 95%CI=2.28-6.6). When compared to EPI patients with zero seizures, those with 6-10 seizures in the prior 4 weeks had higher odds of HR-OSA (OR=1.87, 95%CI=1.11-3.14) and HR-Insomnia (OR=4.44, 95%CI=2.6-7.57). With each 5-point increase in PHQ-9 score in PSYC patients, the odds of HR-OSA increased by 28% (OR=1.28, 95%CI=1.185-1.383), and HR-Insomnia increased by 154% (OR=2.54, 95%CI=2.305-2.79). HR-OSA and HR-Insomnia are highly prevalent in neurological populations and associated with worsening disease.Mr. Mouchati has nothing to disclose. Dr. Katzan has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CSL Behring . The institution of Dr. Katzan has received research support from TEVA Pharmaceuticals. Dr. Mora Munoz has nothing to disclose. Ms. Pascoe has nothing to disclose. Dr. Foldvary-Schaefer has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz. The institution of Dr. Foldvary-Schaefer has received research support from Jazz. The institution of Dr. Foldvary-Schaefer has received research support from Suven. The institution of Dr. Foldvary-Schaefer has received research support from Takeda. Dr. Foldvary-Schaefer has received publishing royalties from a publication relating to health care. Dr. Foldvary-Schaefer has received publishing royalties from a publication relating to health care.