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Abstract Introduction Insomnia symptoms during inpatient rehabilitation are associated with slower recovery progression and longer lengths of stay. In addition to addressing environmental and behavioral factors, understanding medical and psychiatric comorbidities may help clinicians identify patients in most need of insomnia-related assessment, monitoring, or treatment. The present preliminary analysis aimed to characterize the comorbidity profiles of patients with insomnia symptoms and daytime sleepiness newly admitted to a VA subacute rehabilitation neighborhood. Methods 48 Veterans (Mage=72.8±12.1; 97.9%male; 79.2%white) were admitted to the neighborhood following hospital discharge during a 6-month period. Reasons for admission included short-term rehabilitation following acute illness or injury or worsening of an existing medical condition. Within 7 days of admission, Veterans completed the Insomnia Severity Index(ISI) and Epworth Sleepiness Scale(ESS). Medical and psychiatric diagnoses were obtained from electronic medical records. Comorbidity profiling was determined through frequency analyses. Results 52.1%(n=25) of Veterans endorsed at least subthreshold insomnia (ISI≥8), and 33.3% (n=16) of Veterans endorsed excessive daytime sleepiness (ESS10). For Veterans with at least subthreshold insomnia OR excessive daytime sleepiness, the following medical comorbidities were most prevalent: circulatory disease (e.g., coronary artery disease, hypertension) (80%;93.8%) and pain disorder (e.g., spinal stenosis) (76%;75%), respectively. For Veterans with at least subthreshold insomnia OR excessive daytime sleepiness, the following psychiatric comorbidities were most prevalent: anxiety disorder (44%;68.8%), and history of substance use disorder (e.g., alcohol use disorder) (44%;43.8%), respectively. Prevalence of circulatory disease (89%) and pain disorder (90.1%) were more pronounced among Veterans with clinical insomnia (n=11)(ISI ≥ 15), though these findings were not significant. Conclusion While this work is preliminary, the findings support that it may be beneficial for clinicians to assess sleep difficulties upon admission to subacute rehabilitation settings. This may be especially important for patients with medical comorbidities, such as circulatory disease and pain disorders, and/or psychiatric comorbidities, such as anxiety disorder and substance use disorder. Future evaluations should include larger, more diverse samples and longitudinal designs to identify which comorbidities are primary risk factors for greater insomnia severity and daytime sleepiness during subacute rehabilitation. Understanding these risk factors would be essential to addressing insomnia and daytime sleepiness during rehabilitation in order to optimize recovery. Support (if any)
Boeve et al. (Sat,) studied this question.