0957 Multidimensional Sleep Health Is Associated with Affective Instability in Stroke Survivors

Abstract Introduction Affective instability, a form of emotion dysregulation, is defined by rapid and intense shifts in affect and a known precursor of affective disorders. Poor sleep health leads to emotional dysregulation and affective instability. Poor sleep health is common after stroke, but which specific aspects of sleep health are important is unclear. We hypothesized that a multidimensional assessment of sleep health would identify specific factors that contribute to affective instability in stroke survivors. Methods Forty community-dwelling stroke survivors underwent multidimensional sleep health assessment with sleep diaries, the Pittsburgh Sleep Quality Index and ecological momentary assessment of affect and alertness eight times daily for seven days. Sleep health was quantified into 6 domains of the Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU-SATED) framework. Affective instability was quantified using probability of acute change (PAC) and mean squared successive difference (MSSD). Multivariable linear regressions were used to identify sleep health factors associated with affective instability, adjusting for age, sex, and race. Results Instability of depressed affect was associated with lower alertness (MSSD: B=.55, p=.001; PAC: B=.76, p<.001), lower sleep efficiency (B=.35, p=.036), and longer sleep latency (B=.38, p=0.30). Instability of cheerful affect was associated with less regular mid-sleep time (MSSD: B=.57, p<.001; PAC: B=.48, p=.004), less regular sleep duration (B=.43, p=.012), and longer sleep latency (MSSD: B=.39, p=.020; PAC: B=.39, p=.021). Conclusion Lower sleep efficiency, longer sleep latency, lower alertness, and irregular sleep contribute to affective instability among stroke survivors. Future intervention efforts managing these specific factors of sleep health to stabilize affective changes and prevent affective disorders after stroke are needed. Support (if any)