B - 98 Effect of Insomnia on Sustained Attention in Post-Acute Sequelae of COVID-19 (PASC)

Abstract Objective Insomnia symptoms are prevalent among individuals with post-acute sequelae of COVID-19 (PASC) and may, to some extent, reflect virally-mediated neurological changes. Mood disturbance and cognitive impairment, including weaknesses in attention and processing speed, are also observed. There is limited research examining the association between insomnia, mood, and cognition in PASC, which we aimed to elucidate. Methods Patients were 69 consecutive adults (M-age = 46.5 ± 11.6 years; M-education = 15.03 ± 2.66 years; M-TOPF-SS = 104.6 ± =12.58; 69.6% female; 95.7% White) seen for neuropsychological evaluation in a PASC clinic. They completed the Conners Continuous Performance (CPT-3), Symbol Digit Modalities Test, Insomnia Severity Index, Beck Anxiety Inventory, and Beck Depression Inventory as part of a larger battery of measures. Cognitive performance was compared between patients with elevated versus non-elevated insomnia symptoms. Models were also adjusted for mood symptoms via MANCOVA. Results Group demographics were unrelated to mood, sleep, and cognition. MANOVA yielded a significant main effect (Wilks’ Λ = 0.656, F(7,61) = 4.57, p < 0.001), with more CPT-3 commission errors (p < 0.001, ηp2 = 0.247), faster reaction times (p = 0.012, ηp2 = 0.090), and more variable response speed consistency (p = 0.027, ηp2 = 0.071) in those with insomnia. Commission errors and reaction times remained significant after covarying for mood. The insomnia group displayed slower responses across block changes (p = 0.038, ηp2 = 0.065) when mood was controlled. Conclusion Patients with PASC with elevated insomnia symptoms showed greater inaccuracy and more variable reaction times on a sustained attention task, in a pattern suggesting impulsivity, even after controlling for mood symptoms. Findings suggest that improving sleep may ameliorate attention deficits in persons with PASC.