0295 Do Achy Joints Mean Sleepless Nights? Insights from Wearable Data in the All of Us Research Dataset

Abstract Introduction Degenerative musculoskeletal (MSK) conditions such as osteoarthritis, low back pain, neck pain and rheumatoid arthritis, affect approximately 1.3 billion people worldwide. Sleep disturbances including insomnia, poor sleep quality, and sleep disordered breathing, are commonly reported among patients with chronic degenerative MSK conditions, especially osteoarthritis, yet population level studies on this association remain limited. Methods We conducted a retrospective cohort study using Fitbit sleep data from NIH All of Us Registered Tier Dataset v8. Adults with documented arthropathy or spondylosis were included in the test group. Exclusions comprised primary sleep disorders, neurologic or cardiopulmonary conditions affecting sleep, missing Fitbit data, and use of known sedatives (e.g., benzodiazepines, barbiturates). The test group was compared with a control sample of 3,000 individuals randomly selected from 29,956 eligible controls. Sleep duration, efficiency, and stage-specific metrics were derived via standardized R pipelines, and between-group differences were evaluated using two-sample tests and adjusted regression models. Results A total of 5,953 participants were included (test: n = 2,953; control: n = 3,000). Across primary sleep metrics, between-group differences were generally small. Time in bed showed no meaningful difference (386.1 vs. 383.6 min; p = 0.29). Total minutes awake were similar (44.6 vs. 44.4 min; p = 0.64). Restless minutes demonstrated a statistically significant but clinically minimal reduction in the test cohort (15.5 vs. 16.8 min; p = 0.01). The most notable finding was a reduction in minutes spent awake after waking (51.3 vs. 75.2 min; p 0.001), indicating modest but consistent improvement in post-awakening consolidation. Conclusion The MSK cohort exhibited a statistically significant lower number of minutes spent awake after waking. However, other sleep metrics including, time in bed, and total awake minutes, showed minimal variation between the groups. Overall, individuals with MSK conditions demonstrated largely similar sleep profiles to controls, indicating that degenerative MSK conditions have limited impact on objective sleep architecture. Support (if any)