(329) Sleep Aids, Sleep Quality, And Daytime Sleepiness In Emerging Adults With Cystic Fibrosis (CF) On CF Transmembrane Conductance Regulator (CFTR) Modulator Therapy

Background: Sleep disturbances and daytime sleepiness are common among youth and adults with cystic fibrosis (CF). However, little is known about different sleep aids used by patients with CF. Emerging adults (18 to 25 years) with CF are a unique population, experiencing changes in sleep and life transitions that impact sleep quality and daytime sleepiness, while also managing a complex chronic illness. CF transmembrane regulator (CFTR) modulator therapies have significantly improved medical and quality of life outcomes, yet the impact on sleep remains to be determined.

Methods: Emerging adults with CF (EA-CF; n=23, 56.5% female) and without CF (EA-Control; n=21, 71.4% female) completed an online survey that queried (1) frequency of exogenous sleep aid use (i.e., prescription medications, over-the­counter [OTC] sleep aids [e.g., diphenhydramine], melatonin, and marijuana/CBD), (2) subjective sleep quality (PROMIS Sleep Disturbances), and (3) daytime sleepiness (PROMIS Sleep Related Impairment). EA-CF were also asked about perceived changes in falling asleep, night waking frequency and duration, and daytime sleepiness since starting CFTR modulator therapy. Group differences were examined with chi-square analyses for categorical variables and t-tests were used for continuous variables. Due to the small sample, effect sizes (Cramer's V and Cohen's d) are reported rather than p-values.

Results: Prescription sleep aid use was reported by only one CF participant. OTC sleep aid use did not differ by group, but the frequency was significantly greater in EA-CF (large effect size). Use of melatonin did not differ between groups, but EA-CF reported higher doses of melatonin (large effect size). More EA-CF reported CBD/marijuana use compared to EA-Control (medium effect size), with more EA-CF reporting use of CBD/marijuana at least several nights a week (medium effect size). EA-CF reported poorer subjective sleep quality (medium effect size) and greater daytime sleepiness (small effect size). Since starting CFTR modulatory therapy, 26.1 % of EA-CF reported falling asleep faster, 30.4% reported fewer night wakings, 34.8% reported shorter night wakings, 34.8% reported decreased use of sleep medication/aid, and 30.4% reported reduced daytime sleepiness. A summary of results is shown in Table 1.

Conclusions: This study is one of the first to examine sleep aids, sleep quality, and daytime sleepiness in emerging adults with CF on CFTR modulator therapy, with results highlighting the importance of screening for sleep quality, daytime sleepiness, use of exogenous sleep aids to facilitate sleep, and the benefits of CFTR modulator therapy on sleep. Data collection is ongoing.

Acknowledgements: This work was supported by the National Jewish Health Natalie V. Zucker Award.

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