(262) Frequency of Sleep Disorders and Insomnia in Patients with Wilson Disease Identified in Electronic Health Records

Publication Number: 593

Background: Wilson disease (WD) is an autosomal recessive disorder of copper metabolism. Literature has suggested an association between WD and sleep disturbances and complaints, including symptoms of insomnia. Real-world data are limited however and the occurrence of diagnosed insomnia in patients with WD is unknown.

Objectives: To utilize a real-world data source to describe the occurrence of diagnosed sleep disorders, including insomnia, in patients newly diagnosed with WD.

Methods: Patients newly diagnosed with WD were identified between 2016 and 2021 within the TriNetX Dataworks USA Network, an electronic health records database, which includes approximately 76 million patients from 48 healthcare organizations (HCOs) in the USA. Patients were included if they had ≥ 2 ICD codes for WD and at least one year of follow-up before and after diagnosis and no identified history of prescribed WD treatment (chelators or zinc). Patients with sleep disorders were identified via ICD code or an RxNorm code for prescribed sleep aids. The proportion of patients with a sleep disorder in the full TriNetX Dataworks population over five years of age was also determined as an estimate of prevalence of sleep disorders in the general population.

Results: A total of 310 patients with WD were included in the analysis (mean age ± standard deviation (SD) 47 ± 19 years old, 42% male). Sleep disorders (including use of sleep aids) were diagnosed in 49 patients within the year prior to WD diagnosis (15.8%; 95% CI: 11.7%, 19.9%). Insomnia was diagnosed in 24 patients (7.7%; 95%CI: 4.8%, 10.7%) and was the most common of the sleep disorders among patients with WD, accounting for 55.8% of the patients with sleep disorders. In the year after diagnosis, 73 patients had a sleep disorder (23.5% (95%CI: 18.8%, 28.3%) and insomnia remained the most common sleep disorder (40.6%). Similar findings were observed in sensitivity analyses among patients with two years look back and two years of follow-up data, and in analyses restricted to patients not prescribed zinc or chelators (n=253, 81.6%). In the full TriNetX Dataworks population, 12.3% of patients had a diagnosed sleep disorder and 3.4% had insomnia. Patients with WD with insomnia were on average 54 years old, similar to the insomnia patients in the overall TriNetX network.

Conclusions: Using electronic health records, these findings suggest that the prevalence of diagnosed sleep disorders, especially insomnia, in WD may be greater than general healthcare seeking population. Whether increased insomnia and sleep disorder in patients with WD is associated with co-morbidities, other treatments, or other factors is unclear.