1084 TRAUMA EXPOSURE POTENTIATES THE RELATIONSHIP BETWEEN SLEEP AND CHRONIC PAIN IN VETERANS WITH TBI AND PTSD

Abstract Introduction: One of the main sequelae of mild traumatic brain injury (mTBI) is sleep-wake disturbances (e.g., excessive daytime sleepiness, insomnia and circadian rhythm disorders), which is present in 50–70% of civilians and Veterans with mTBI. In addition to sleep-wake disturbances, mTBI is commonly associated with headache and chronic pain. As the relationship between sleep-wake disturbances and chronic pain/headache may be potentiated by the co-existence of trauma, the purpose of this study is to describe the association between sleep-wake disturbances and pain in a large sample of Veterans without trauma exposure, with mTBI, with post-traumatic stress disorder (PTSD), and with co-morbid mTBI+PTSD. Methods: Veterans without trauma exposure (Control; n=309), with mTBI (n=117), with PTSD (n=130), and with comorbid mTBI and PTSD (mTBI+PTSD; n=96) were consented and enrolled from the VA Portland Health Care System Sleep Disorders Laboratory. Data collected included overnight in-lab polysomnography, self-reported sleep-wake disturbances assessed via the insomnia severity index (ISI), and the presence/severity of headache/pain as assessed via the NIH PROMIS Global Health scale. TBI and PTSD symptom severity was assessed using the Rivermead Post-Concussive Questionnaire (RPQ) and the PTSD Checklist (PCL-5), respectively. Results: Trauma exposure was associated with worse ISI scores (Control=13 ± 0.3, mTBI=15 ± 0.6, PTSD=18 ± 0.5, and mTBI+PTSD=19 ± 0.5; max=26). ISI was positively correlated with RPQ scores in mTBI Veterans (r=0.65, P