0106 Cognitive-Emotional Features of Insomnia Phenotypes Based on Objective Sleep Duration in Young Adults

Abstract Introduction The association of insomnia with adverse mental health outcomes is well-established. Prior research has suggested that cognitive-emotional predisposition to mental health disorders is shared across insomnia phenotypes. However, no study to date has examined this association in insomnia phenotypes based on objective sleep duration in young adults. Methods We studied 270 young adults (median 25 years, 53% female, 24% racial/ethnic minority) from the Penn State Child Cohort who underwent a 9-hour polysomnography (PSG) recording, clinical history, and self-report surveys. Insomnia symptoms were defined as difficulties initiating or maintaining sleep, an insomnia diagnosis or complaint, and/or sleep medication use. PSG-measured short sleep duration was defined by the median of the sample (i.e., < 7-h), identifying normal sleep duration (NSD), short sleep duration (SSD), insomnia with normal sleep duration (INSD) and insomnia with short sleep duration (ISSD). Participants completed the Ford Insomnia Response to Stress Test (FIRST), Arousal Predisposition Scale (APS), Personality Inventory for DSM-5 (PID-5-BF), Pre-Sleep Arousal Scale (PSAS), and Depression, Anxiety, and Stress Scale (DASS). A multivariate general linear model tested mean differences in cognitive-emotional outcomes across the four groups, while adjusting for sex, race/ethnicity, age, waist circumference, sleep apnea, cardiometabolic disorders, medication and substance use. Results Compared to NSD or SSD, both INSD and ISSD showed significantly higher FIRST (Ps< 0.001), APS (Ps< 0.05), PID-5-BF (Ps< 0.01), PSAS (Ps< 0.001), and DASS (Ps< 0.05) scores, except in the PID-5-BF antagonism and disinhibition trait domains. SSD showed significantly higher FIRST scores compared to NSD (P< 0.05), but no other significant differences were observed on any other scale between SSD and NSD. Conclusion Sleep reactivity, cognitive-emotional arousability, internalization, and negative affectivity are trait features of insomnia, which help perpetuate its chronicity and put all phenotypes at risk of adverse mental health outcomes. These data also suggest that sleep reactivity may be a trait present in a subset of short sleepers at risk of developing insomnia. Support (if any) NIH (R01 HL136587, R01 MH118308, UL1 TR00127)