1128 Prevalence of Physiologic Obstructive Sleep Apnea Risk Phenotypes and Sleep Durations Among Adults with Gambling Disorder: A Clinical Cohort Analysis

Abstract Introduction Gambling disorder (GD) is associated with poor sleep and increased cardiometabolic risk. However, the prevalence and physiologic risk profile of obstructive sleep apnea (OSA) in GD remains unknown. Classic OSA risk factors—male sex, obesity, hypertension, and older age—may influence sleep health in this population. This study examined OSA-risk factors and sleep duration in adults seeking treatment for GD. Methods Demographic variables and clinical data were collected at intake from 736 adults receiving state-funded GD treatment in California. Variables included: age, sex, BMI, hypertension, and GD severity measured using the NORC Diagnostic Screen for Gambling Disorders (NODS). Self-reported habitual sleep duration (hours/night) was obtained at 30-, 90-, or 365-days after intake. Four physiologic OSA-risk markers—male sex, obesity (BMI ≥30 kg/m²), hypertension, and age >50 years—were summed to create a 0–4 OSA-risk burden score. Group differences were analyzed using ANOVA and t-tests. Associations between sleep duration, OSA-risk count, and GD severity were assessed using Spearman correlations. Sixteen physiologic phenotypes were evaluated for sleep-duration differences. Results OSA-risk burden distribution: 0 factors (7.1%), 1 factor (44.7%), 2 factors (36.4%), 3 factors (11.4%), and 4 factors (0.4%). Male sex, obesity, hypertension, and age >50 years increased monotonically across OSA-risk levels (all p < 0.001). Severe GD prevalence did not differ by OSA-risk burden (p = 0.87). Mean reported sleep duration was similar across OSA-risk groups (7.3, 7.2, 6.9, 7.0, 7.0 hours; p = 0.349), GD severity categories (7.2–7.0 hours; p = 0.50), and sex (7.09 vs 7.13 hours; p = 0.58). Sleep duration showed a weak inverse association with OSA-risk count (ρ = –0.10, p = 0.0047) and no association with GD severity (ρ = –0.04, p = 0.34). Three phenotypes demonstrated short sleep: • Male + hypertension + age >50 (non-obese): 4.7 h (N=3) • Male + obesity + hypertension (≤50): 6.00 h (N=10) • Female + obesity + age >50: 6.64 h (N=58) Conclusion Nearly half of adults with GD exhibited ≥2 physiologic OSA-risk factors. Overall sleep duration did not vary by GD severity or OSA-risk burden, but specific physiologic phenotypes demonstrated reduced sleep, indicating phenotype-level heterogeneity in sleep vulnerability. Support (if any) Support from UCLA Gambling Studies Program.