(PS1-93) Mental Health Correlates with Obstructive Sleep Apnea Symptoms Among Veterans Seeking Treatment for Military Sexual Trauma

Obstructive Sleep Apnea (OSA) is a pervasive health concern among Veterans (Alexander et al., 2016). Research increasingly indicates trauma, including Military Sexual Trauma (MST), may be associated with OSA (Spitzer et al.,  2024; Pal et al., 2023; Krakow, et al., 2021).  Veterans (N = 106, 70.2% female, average age 43.5 years, SD = 12.5 years) seeking mental health care related to MST presented to a Midwestern specialty trauma clinic for evaluation and treatment. Veterans completed a semi-structured interview and the Pittsburgh Sleep Quality Index (PSQI) including screening items for potential OSA-related disturbances: nocturia, breathing comfort, loud snore/cough, and feeling too hot (rated from 0-3 with higher scores denoting more frequent past-month challenges with sleep due to this symptom). We did not investigate items related to challenges with sleep maintenance due to more limited specificity of sleep persistence complaints. We further evaluated relationships between OSA-laden PSQI items and surveys assessing the following concerns: depression (Patient Health Quesionnaire-9), PTSD (PTSD Checklist for DSM-5), worry (Penn State Worry Questionnaire), and pain/somatic complaints (Patient Health Questionnaire-15). Nocturia was the most frequently endorsed OSA-related sleep complaint (M=2.04) and evidenced small-to-moderate relationships with elevated depression (r=.24, p = .01), PTSD (r = .28, p = .005), and somatic complaints (r = .21, p = .029). Sleep disturbances associated with discomfort breathing were less commonly endorsed (M=0.09) though evidenced the strongest within-study association with depression (r=.43, p < .001) and somatic symptoms (r=.46, p < .001) and moderate relationships with PTSD (r=.33, p = .001). Sleep impaired by loud snoring or coughing was the second least commonly endorsed item (M=1.13) and demonstrated only small-to-moderate relationships with PTSD (r=.21, p =.037) and somatic complaints (r=.23, p = .02). Sleep disturbances associated with being too hot at night were the second most commonly endorsed item (1.55) and demonstrated moderate-to-large relationships with depression and PTSD (r = .4, p < .001), somatic complaints (r = .41, p < .001) and a small-to-moderate relationship with worry (r=.30, p = .047). Results suggest relationships between potential signs of OSA and multiple mental and physical health complaints. Moreover, while PTSD and somatic complaints were associated with each OSA-laden item investigated, worry and depression evidenced more nuanced pattern with mental health phenotypes and there was notable variability in the strength of symptom/OSA item relationships. While persons of all genders experience MST, it is more common among females (Department of Veterans Affairs, 2021). This research suggests screening tools may not be adequately capturing all of the risk factors for OSA, and females, in particular, may evidence variable relationships with mental health concerns and certain types of symptoms suggestive of OSA. Advocacy in the medical community may be necessary in order to bring equity to screening for a deleterious health condition that has many negative health correlates.