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SLEEP HEALTH IN ADULTS WITH IMMUNE THROMBOCYTOPENIA: QUALITY OF LIFE DATA FROM THE PLATELET DISORDER SUPPORT ASSOCIATION (PDSA) PATIENT REGISTRY
Author(s): ,
Jennifer DiRaimo
Affiliations:
Platelet Disorder Support Association,Cleveland,United States
,
Caroline Kruse
Affiliations:
Platelet Disorder Support Association,Cleveland,United States
,
Donald Arnold
Affiliations:
Department of Medicine,McMaster Centre for Transfusion Research, McMaster University and Canadian Blood Services,Hamilton,Canada
Alexandra Kruse
Affiliations:
Platelet Disorder Support Association,Cleveland,United States;Tulane University School of Medicine,New Orleans,United States
EHA Library. DiRaimo J. 06/09/21; 324875; EP1154
Jennifer DiRaimo
Jennifer DiRaimo
Contributions
Abstract
Presentation during EHA2021: All e-poster presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: EP1154

Type: E-Poster Presentation

Session title: Platelet disorders

Background
While poor sleep health has been documented in several autoimmune diseases, it’s never been evaluated in patients with immune thrombocytopenia (ITP), an autoimmune bleeding disorder. In this study, sleep health refers to participants’ overall satisfaction with their sleep, sleep quality, effort it takes to fall asleep, and problems sleeping.

Aims
We reviewed data from the ITP Natural History Patient Registry on sleep health among adults with ITP to examine the extent of sleep disruption in ITP patients and whether overall sleep health is worse among those receiving treatment, particularly a corticosteroid.

Methods
Adults >18 years with ITP completed both a demographic and a Quality of Life (QoL) survey regarding their symptoms within the last seven days.

Results
Within the 310 respondents, 248 were female (80%), 260 from the USA (83%), 180 were employed (58%), 288 insured (93%), and 235 were under the age of 65 (76%, range 18-100 years). Overall, 249 (80%) reported they had problems sleeping, 217 (70%) reported they were not very satisfied with their sleep, 155 (50%) worried about falling asleep, and 180 (58%) reported difficulties falling asleep. When asked about the quality of their sleep, 162 (52%) reported fair/poor sleep quality and 244 (79%) indicated their sleep was restless. Only 100 (32%) respondents indicated their sleep was refreshing.  

Of the 310 respondents, 129 (42%) were receiving treatment for ITP. Among those, 102 (79%) reported they had problems sleeping, 92 (71%) were not very satisfied with their sleep, 68 (53%) worried about falling asleep, and 80 (62%) reported difficulties falling asleep. When asked about the quality of their sleep, 72 (56%) reported fair/poor sleep quality and 107 (83%) indicated their sleep was restless. Only 40 (31%) respondents reported their sleep was refreshing. Sleep health was not significantly worse in the treatment group compared to the non-treatment group despite high levels of poor sleep health.


Within the 129 respondents on treatment, 30 (10%) were receiving corticosteroids. Among those, 28 (90%) reported problems sleeping, 25 (84%) were not very satisfied with their sleep, 19 (64%) worried about falling asleep, 22 (74%) reported difficulties falling asleep, 20 (67%) reported fair/poor quality of sleep, 28 (90%) reported restless sleeping, and 16 (53%) reported their sleep was refreshing. Corticosteroid users reported more problems sleeping than those receiving a non-corticosteroid treatment and this difference was significant (p=.033, p<.05). Corticosteroid users also reported more restless sleep compared to the 181 respondents not receiving any treatment and this difference was found to be significant (p=0.044, p<.05). No other significant differences in sleep health were identified between corticosteroid users and non-corticosteroid users, or between corticosteroid-users and those not receiving treatment.

Conclusion
Overall, adults with ITP reported high levels of poor sleep health above what is expected from general population data, particularly among those receiving corticosteroids. Certain elements of sleep health were significantly worse among corticosteroid users, whereas other elements did not appear to be related to treatment for ITP. These results could be due to the low sample of participants currently taking corticosteroids in the study. Further work is needed to understand what additional factors aside from corticosteroids may be influencing poor sleep health in this patient population.

Keyword(s): Bleeding disorder, Corticosteroids, Immune thrombocytopenia (ITP), Quality of life

Presentation during EHA2021: All e-poster presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: EP1154

Type: E-Poster Presentation

Session title: Platelet disorders

Background
While poor sleep health has been documented in several autoimmune diseases, it’s never been evaluated in patients with immune thrombocytopenia (ITP), an autoimmune bleeding disorder. In this study, sleep health refers to participants’ overall satisfaction with their sleep, sleep quality, effort it takes to fall asleep, and problems sleeping.

Aims
We reviewed data from the ITP Natural History Patient Registry on sleep health among adults with ITP to examine the extent of sleep disruption in ITP patients and whether overall sleep health is worse among those receiving treatment, particularly a corticosteroid.

Methods
Adults >18 years with ITP completed both a demographic and a Quality of Life (QoL) survey regarding their symptoms within the last seven days.

Results
Within the 310 respondents, 248 were female (80%), 260 from the USA (83%), 180 were employed (58%), 288 insured (93%), and 235 were under the age of 65 (76%, range 18-100 years). Overall, 249 (80%) reported they had problems sleeping, 217 (70%) reported they were not very satisfied with their sleep, 155 (50%) worried about falling asleep, and 180 (58%) reported difficulties falling asleep. When asked about the quality of their sleep, 162 (52%) reported fair/poor sleep quality and 244 (79%) indicated their sleep was restless. Only 100 (32%) respondents indicated their sleep was refreshing.  

Of the 310 respondents, 129 (42%) were receiving treatment for ITP. Among those, 102 (79%) reported they had problems sleeping, 92 (71%) were not very satisfied with their sleep, 68 (53%) worried about falling asleep, and 80 (62%) reported difficulties falling asleep. When asked about the quality of their sleep, 72 (56%) reported fair/poor sleep quality and 107 (83%) indicated their sleep was restless. Only 40 (31%) respondents reported their sleep was refreshing. Sleep health was not significantly worse in the treatment group compared to the non-treatment group despite high levels of poor sleep health.


Within the 129 respondents on treatment, 30 (10%) were receiving corticosteroids. Among those, 28 (90%) reported problems sleeping, 25 (84%) were not very satisfied with their sleep, 19 (64%) worried about falling asleep, 22 (74%) reported difficulties falling asleep, 20 (67%) reported fair/poor quality of sleep, 28 (90%) reported restless sleeping, and 16 (53%) reported their sleep was refreshing. Corticosteroid users reported more problems sleeping than those receiving a non-corticosteroid treatment and this difference was significant (p=.033, p<.05). Corticosteroid users also reported more restless sleep compared to the 181 respondents not receiving any treatment and this difference was found to be significant (p=0.044, p<.05). No other significant differences in sleep health were identified between corticosteroid users and non-corticosteroid users, or between corticosteroid-users and those not receiving treatment.

Conclusion
Overall, adults with ITP reported high levels of poor sleep health above what is expected from general population data, particularly among those receiving corticosteroids. Certain elements of sleep health were significantly worse among corticosteroid users, whereas other elements did not appear to be related to treatment for ITP. These results could be due to the low sample of participants currently taking corticosteroids in the study. Further work is needed to understand what additional factors aside from corticosteroids may be influencing poor sleep health in this patient population.

Keyword(s): Bleeding disorder, Corticosteroids, Immune thrombocytopenia (ITP), Quality of life

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