0362 Obstructive Sleep Apnea, Insomnia and a Novel Approach to Separating Dangerous Bedfellows – Just “ASHQ”

Abstract Introduction Obstructive sleep apnea (OSA) can lead to numerous adverse health sequelae, increased medical costs and impaired quality of life, and insomnia may have similar consequences. The frequent co-occurrence of OSA and insomnia (comorbid insomnia and sleep apnea, COMISA) results in a bi-directional, synergistic relationship with greater symptomatology and refractory treatment outcomes. Poor sleep hygiene may directly contribute to insomnia, and identifying and correcting maladaptive sleep habits could improve sleep and management of COMISA. Numerous questionnaires are available to measure subjective sleepiness, fatigue and sleep quality, but there are no sleep hygiene surveys to identify the plethora of contemporary, maladaptive lifestyle behaviors that may contribute to insomnia. An instrument to detect detrimental sleep habits could help COMISA patients to optimize sleep hygiene, improve insomnia, and enhance treatment. Methods We recently developed a sleep hygiene questionnaire (Atlantic Sleep Hygiene Questionnaire, ASHQ) consisting of 20 detrimental sleep habits based on a critical analysis of the current sleep hygiene literature. In a prior validation study, ASHQ score strongly correlated with sleepiness, fatigue and subjective sleep quality in 700 adult patients with various sleep-related diagnoses. We now administered the ASHQ to a new cohort of 80 patients with only OSA. Patients also completed a single item sleep quality assessment (Sleep Quality Score, SQS) and a screening tool for insomnia (Insomnia Severity Index, ISI). ASHQ scores were summarized and compared to SQS and ISI survey results, and correlations were analyzed for each assessment. Results ASHQ and ISI scores were elevated in a majority of OSA patients, consistent with COMISA. ASHQ scores were significantly associated with SQS and ISI scores. There was a direct correlation between detrimental sleep habits, sleep quality and insomnia, confirming the validity of the ASHQ to assess sleep hygiene and its potential risk in patients with OSA and COMISA. Conclusion The ASHQ is a novel instrument to assess sleep hygiene, and ASHQ scoring strongly correlates with both sleep quality and insomnia in patients with OSA. ASHQ may be a useful tool to identify COMISA, improve sleep hygiene and concomitant insomnia, and facilitate treatment of underlying OSA. Support (if any)