0987 Independent Effects of Multiple Sleep Disorders on Cardiometabolic Disease: Evidence from a Costa Rican Clinical Cohort

Abstract Introduction Introduction: Multiple sleep disorders frequently coexist and may jointly contribute to cardiometabolic risk. However, the independent effect of accumulating sleep disorders on hypertension (HTN) and type 2 diabetes (DM2) is not well understood. This study evaluated the prevalence of common sleep disorders, quantified the burden of coexisting disorders, and assessed their associations with HTN and DM2 in models adjusted for age, sex, and body mass index (BMI). Methods Methods: Cross-sectional analysis of polysomnography from 3,154 Costa Rican adults. Insomnia, restless legs, parasomnia, bruxism, and obstructive sleep apnea (OSA; apnea–hypopnea index >5 events/hour), were summed to create a sleep disorder burden score (0, 1, 2, or ≥3 disorders). HTN and DM2 were identified using cardiovascular risk documentation. Primary logistic regression models were adjusted for age and sex, while secondary models further adjusted for BMI. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results Results: The sample included 1,466 women (48.1%) and 1,589 men (50.4%). Prevalence of individual disorders was 3.4% for insomnia, 10.8% for restless legs, 9.4% for parasomnia, 6.2% for bruxism, and 80.6% for OSA. Based on the five-disorder burden, 17.6% had 0 disorders, 65.0% had 1 disorder, 11.4% had 2 disorders, and 6.0% had ≥3 disorders. Crude prevalence of HTN rose from 32.2% in those with 0 disorders to 54.1%, 58.8%, and 64.7% for 1, 2, and ≥3 disorders; DM2 increased from 15.5% to 27.5%, 29.5%, and 35.3%, respectively. In BMI-adjusted models, sleep disorder burden remained strongly associated with HTN: 1 disorder (adjusted OR [aOR] 1.50, 95% CI 1.18–1.91), 2 disorders (aOR 1.81, 95% CI 1.32–2.49), and ≥3 disorders (aOR 2.65, 95% CI 1.78–3.95). For DM2, BMI adjustment attenuated associations; however, ≥3 disorders remained significant (aOR 1.86, 95% CI 1.22–2.83), while 1 and 2 disorders showed nonsignificant trends. Age and BMI were strong independent predictors of both outcomes. Conclusion Conclusions: Accumulation of sleep disorders was strongly associated with hypertension and, to a lesser degree, type 2 diabetes, with the greatest risk observed in patients with three or more disorders. Support (if any) Any