0127 Characterizing Actigraphic Sleep Profiles and Their Associations with Health Outcomes in Gulf War Veterans

Abstract Introduction Gulf War (GW) veterans continue to report chronic health issues, including sleep disturbances, over 30 years post-deployment. While prior research has focused on self-reported sleep symptoms, few studies have examined objective sleep profiles in this population. This study aimed to identify actigraphy-derived sleep patterns and their associations with health outcomes in GW veterans with Gulf War Illness (GWI). Methods Data were drawn from a larger randomized clinical trial evaluating integrative health interventions for veterans with GWI. Participants (N=82; Mage=54.1±7.1y, 86.6% male) wore wrist actigraphy devices for ≥7 consecutive nights. Sleep parameters (e.g., total sleep time TST, sleep efficiency SE, wake after sleep onset WASO, motor activity, number of awakenings) and variability metrics were extracted. Principal components analysis (PCA) was used to derive actigraphic sleep profiles. These components were correlated with self-reported sleep quality (PSQI), mental and physical health, pain, fatigue, and cognitive function. Multiple regression models examined predictors of each sleep component. Results Three principal components (PCs) emerged: PC1: Higher WASO, motor activity, and awakenings (fragmented sleep); PC2: Lower TST and SE (short, inefficient sleep); PC3: Greater variability in sleep timing and duration (irregular sleep). PC1 was positively associated with age and PSQI global scores and negatively associated with physical functioning (VR-36 PCS). PC2 was inversely associated with PSQI sleep quality, while PC3 was positively associated with depressive symptoms (PHQ-9) and negatively associated with mental functioning (VR-36 MCS). Regression models showed PSQI components (e.g., sleep disturbance, latency) significantly predicted objective sleep profiles. Conclusion Distinct objective sleep components were identified among GW veterans with GWI, each were associated with different health outcomes. Fragmented and irregular sleep patterns were linked to poorer physical and mental health, while short, inefficient sleep was associated with subjective sleep quality. These findings underscore the importance of multidimensional sleep assessment in providing a more accurate view of sleep health and in determining potential intervention targets in a clinical population of veterans that continue to self-report sleep disturbances 30 years post-deployment. Support (if any) This research was supported by the Department of Veterans Affairs, Office of Research and Development (ClinicalTrials.gov Identifier: NCT02180243).