0803 Insomnia, Mood, and Quality of Life in Children and Young Adults with Congenital Heart Disease

Abstract Introduction While mortality rates have decreased in patients with congenital heart disease (CHD), numerous comorbidities associated with CHD persist, including decreased health-related quality of life (HRQOL), depressed mood, and sleep problems. Insomnia is known to worsen mood and HRQOL in children without CHD, therefore we examined the relationship between insomnia, mood and HRQOL. Methods We recruited 38 individuals with CHD between the ages of 4-25 years and assessed insomnia, health-related quality of life, anxiety, and depression using the Pediatric Insomnia Severity Index (PISI), Pediatric Quality of Life Inventory (PedsQL), Screen for Child Anxiety Related Disorders (SCARED), and Center for Epidemiological Studies Depression Scale for Children (CES-DC). T-tests were used to compare differences in HRQOL, anxiety, and depression in individuals with CHD with and without comorbid insomnia. Logistic regression was used to assess whether the presence of insomnia can predict increased odds of clinically significant anxiety or depression. Results Individuals with CHD and insomnia (PISI score ≥8) demonstrated significantly lower health-related quality of life, more depressive symptoms, and higher total anxiety compared to individuals with CHD without insomnia. Individuals with insomnia had a mean HRQOL score of 63.1 ± 15.6 vs 77.8 ± 18.9 in the group without insomnia (p=0.03). Individuals with insomnia had a mean total depression score on the CES-DC scale of 21.5 ± 14.6 vs 7.3 ± 5.6 for those without insomnia (p=0.009). Clinically significant depression in the insomnia group was 24 times greater (95% confidence interval [95% CI] 2.3-247.4, p=0.008) compared to those without insomnia. The mean total anxiety score for individuals with insomnia was 25.0 ±19.6 compared with 12.4 ± 10.3 in those without insomnia (p=0.03), and the odds of clinically significant anxiety in the insomnia group vs those without insomnia was 4.44 (95% CI 0.9-21.8, p=0.07). Conclusion Insomnia is associated with markedly worse HRQOL, depression and anxiety in individuals with CHD. Further study is needed to evaluate the role of insomnia recognition and treatment in order to improve HRQOL and mood in children and young adults with CHD. Support (if any) No support