1136 Sleep Disorders in Children and Adolescents with Long COVID

Abstract Introduction Recognition of Long COVID is increasing and sleep disturbances are common to this population. This study describes sleep disorders and associated comorbidities in youth with Long COVID. Methods This is a retrospective cross-sectional study of patients initially presenting to the Long COVID clinic. We examined the prevalence of sleep disturbances (SD) and compared those with and without SD in comorbidity and symptomatology. Single-factor regression analyses were used to explore the relationship between SD and patient well-being. Multi-factor regressions analyses with PROMIS SD score as the predictor and age as a continuous covariate were analyzed for the several response variables: child well-being, general fatigue, sleep/rest fatigue, cognitive-fatigue, total fatigue, anxiety, and depression scores. Results Of 250 patients: age ranged 3-24 years(mean 14.6± 3.4years), predominantly female(157/250;63%), white(202/81%);and non-Hispanic(204/250;82%). Patients with SD made up 26%(64/250): 28% circadian rhythm disorders, 31% insomnia, and 1.2% hypersomnia. Compared to the non-SD group, the SD group was more likely to report comorbidities: abdominal pain(52% vs37%, p=0.035), nausea(64% vs52% p=0.084), constipation(50% vs26% p< 0.001), anxiety(89% vs53% p< 0.001), depression (48% vs27% p=0.002), ADHD(27% vs27% p=0.008), headaches(88% vs67%, p=0.002), dizziness (83% vs52%, p< 0.001), POTS(28% vs16%, p=0.027), brain fog(47% vs29%, p=0.009), fatigue (95% vs77%, p=0.001), appetite loss(47% vs29%, p=0.007), and fever(47% vs72%, p=0.053). Using regression analyses, higher PROMIS SD scores negatively associated with child well-being scores (β2= -0.71±0.2; F2, 63=6.37, P< 0.001, R2=0.17), sleep/rest fatigue(β2=-0.51±0.26; F2, 63=5.81, P=0.004, R2=0.16), and total fatigue(β2=-0.65 ±0.2; F2, 63=8.05, P< 0.001, R2=0.20). No significant relationships were found with general/cognitive fatigue scores. Positive correlations found between PROMIS SD scores and anxiety and depression t-scores(β2= 0.26±0.10; F2, 63=3.08, P=0.05, R2=0.09; and β2=0.30±0.11; F2, 65=3.74, P=0.03, R2=0.11, respectively). Conclusion Sleep disorders are prevalent among youth with long-COVID, often coexisting with higher rates of physical, neurological, and psychological symptoms. Higher PROMIS SD scores predict lower child well-being, and higher mood disorder scores. While other factors likely impact long-COVID outcomes, sleep plays an integral role. These findings suggest that SD is a key factor in the overall health and mood of children with Long-COVID, emphasizing the need for integrated care approaches that address both sleep and psychological health. Support (if any)