Abstract Details

Title The Impact of Anxiety on Subjective and Objective Wakefulness in Warfighters With Insomnia

Topic Sleep

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-007

Objective NA

Background Insomnia and anxiety are highly prevalent among the warfighter population. The unique stressors of military service often lead to a state of sustained hyper-arousal that persists long after missions are complete. Chronic anxiety may cause a perceptual distortion of sleep (i.e., someone’s subjective experience of wakefulness diverges from their objective sleep data), and a discrepancy in sleep quality measures poses a challenge for doctors to adequately treat patients. We hypothesized that warfighters with higher anxiety scores on the State Trait Anxiety Inventory (STAI) will report poorer sleep quality in daily sleep diaries (even on nights of objectively good sleep as measured by Fitbit) due to anxiety-driven emotional retrospective distortion.

Design/Methods We selected N=35 participants from a larger clinical trial (N=52) who completed the State-Trait Anxiety Inventory (STAI) and had at least five nights of Fitbit data (total awake time) and self-reported amount of time they believed they were awake the night prior in a sleep diary. We first used Bland Altman plots on discrete anxiety groups (High-Medium = ≥ 38-44, Low = ≤37 STAI Trait Value), and then used a linear mixed-effects model on the difference in subjective (sleep diary) and objective (Fitbit) wakefulness with the continuous STAI and night as covariates and a random intercept for subject ID.

Results The low anxiety group (N=17) reported less wakefulness in the sleep diary than recorded by FitBit (-14.05 minutes). The medium-high (N=18) anxiety groups reported more wakefulness in the sleep diary than recorded by FitBit (6.15 minutes). The linear mixed-effects model showed a trend towards significance (p=0.092).

Conclusions Warfighter anxiety may impact their perception of wakefulness. The positive mean bias for higher anxiety participants indicates an overestimation of self-reported wakefulness (subjective metric) vs. as shown in the Fitbit data (objective metric), providing insights for targeted sleep intervention design.

Authors/Disclosures
Claire M. Akard PRESENTER	Ms. Akard has nothing to disclose.
Rayomand V. Kapadia	Mr. Kapadia has nothing to disclose.
Amanda Studnicki, PhD	Dr. Studnicki has received personal compensation for serving as an employee of The Geneva Foundation. Dr. Studnicki has received research support from National Institute of Health.
Elizabeth Metzger	Ms. Metzger has received personal compensation for serving as an employee of The Geneva Foundation. Ms. Metzger has received research support from University of Michigan .
Ethan R. Cheraghpour	Mr. Cheraghpour has nothing to disclose.
J. Kent Werner, Jr., MD, PhD (Uniformed Services University)	Dr. Werner has received personal compensation for serving as an employee of Cogentis Therapeutics. Dr. Werner has stock in Cogentis Therapeutics. Dr. Werner has received intellectual property interests from a discovery or technology relating to health care. Dr. Werner has received intellectual property interests from a discovery or technology relating to health care. Dr. Werner has received personal compensation in the range of $100,000-$499,999 for serving as a Neurologist with United States Navy. Dr. Werner has received personal compensation in the range of $50,000-$99,999 for serving as a CEO / CoFounder with Cogentis Therapeutics.

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