(758.1) The Relation of Subjective and Objective Assessment of Sleep quality with Post Concussive Symptoms in Veterans

Poster Board Number: E489

Kamila Pollin (Washington DC VA Medical Center), Immanuel Samuel (Washington DC VA Medical Center, Washington DC VA Medical Center, Henry M Jackson Foundation for the Advancement of Military Medicine), Charity Breneman (Washington DC VA Medical Center, Henry M Jackson Foundation for the Advancement of Military Medicine), Ryan Brewster (Washington DC VA Medical Center), Matthew Reinhard (Washington DC VA Medical Center), Michelle Costanzo (Washington DC VA Medical Center)

Sleep complaints are a significant and persistent health problem reported by military Veterans. Veterans with traumatic brain injury (TBI) experience a higher incidence of sleep disturbances, with mild TBI (mTBI) resulting in chronic sleep disruption post injury. However, the relation between sleep and mTBI history is still poorly understood.

Purpose: The purpose of this study is to assess sleep using subjective (Pittsburgh Quality Sleep index; PSQI) and objective (actigraphy) measurements in Veterans with a history of mTBI using remote assessments.

Methods:  Seven Veterans (7 Males; age: 54±7yrs, body mass index (BMI): 31±7 kg/m2 mean±SD) completed a telemedicine VA clinical evaluation and enrolled in the study. Participants completed web-based versions of the PSQI to assess subjective sleep quality (range 0-21) and the Neurobehavioral Symptom Inventory (NSI) to assess post concussive syndrome (PCS) symptoms (range 0-88). Participants wore a wrist-worn actigraph (wGT3X-BT) over a 7-day baseline period to measure total sleep time and sleep variability (standard deviation) from home. Data were analyzed using Pearson’s correlations.

Results: NSI scores are significantly correlated with global PSQI (R2=0.81, P=0.02) where higher NSI scores are associated with a greater PSQI total score. There is no relation between NSI score and sleep time (R2=0.22, P=0.34). There are trending relations between sleep time variability (R2=0.50, P=0.07) and sleep disturbances (R2=0.5, P=0.10; ex. Feeling too hot or too cold, having bad dreams) and NSI, such that those with higher NSI scores have greater sleep variability and sleep disturbances.

Conclusion: Home-based assessments offer a promising means of monitoring sleep in Veterans. Our preliminary data suggests that subjective measurement of sleep relate to PCS symptoms, however trending results suggest that specific features of sleep quality may be affected by mTBI history. Remote evaluations are critical to understand sleep quality of Veterans to aid improvements in PCS symptoms following mTBI.