200 Section - Sleep and Neuropathic Disorders: Insights into Risk and Comorbidity Patterns Using the All of Us Research Program

Objectives : Determine whether sleep disorders correlate with a higher risk of developing neuropathic disorders, neuropathy, and greater neuropathic symptom severity.

Design: We reviewed All of Us Registered Tier Dataset v8, including patients with neuropathy diagnosed at least 7 days after a sleep disorder diagnosis (“Cohort 1”) and neuropathy-only patients (“Cohort 2”). Exclusions included those deceased, history of stroke, hypothyroidism, HIV/AIDS, alcohol use disorder, chemotoxicity, or hematologic disorders. Analyses were conducted using RStudio.

Results: A total of 27,444 participants were included in Cohort 1, and 73,415 in Cohort 2. Lumbar radiculopathy (LR) following insomnia was the most common neuropathic disorder among patients with sleep disorders, occurring in 4.9% of cases. Insomnia was associated with a 15.6% higher risk of polyneuropathy (RR 1.16, 95% CI 1.04–1.29), while obstructive sleep apnea (OSA) conferred a 2.6% higher risk of LR (RR 1.03, 95% CI 0.95–1.11). Cohort 1 participants were older (63.9 vs. 62.02 years) and had higher BMI (33.12 vs. 31.15). Pain scores were elevated in Cohort 1 (4.36 vs. 3.92, p < 0.001), and mild-to-moderate fatigue was reported in both groups (p < 0.001).

Conclusion: Insomnia and OSA were associated with a higher risk of specific neuropathic disorders, particularly polyneuropathy and lumbar radiculopathy, respectively. Older age, higher BMI, and elevated pain scores may further characterize populations at greater risk, highlighting the need for targeted management strategies in patients with sleep disorders.