A290 SLEEP, Volume 46, Supplement 1, 2023 Abstract citation ID: zsad077.0659 0659 NIGHTMARES IN THE ACUTE AFTERMATH OF TRAUMA PREDICT LATER SUICIDAL IDEATION IN TRAUMA SURVIVORS Grace Seymour 1 , Anthony Reffi 1 , David Moore 1 , Gregory Mahr 1 , Christopher Drake 1 1 Henry Ford Health Introduction: Nightmares are a common occurrence after expe- riencing a traumatic event and are a symptom of post-traumatic stress disorder (PTSD). Additionally, nightmares are associated with higher levels of suicidal ideation, attempt, and death from suicide. Nightmares may be an early sign of suicide risk in pop- ulations that have experienced trauma, however, there are no studies that have investigated this potential link. This study aims to determine whether more severe nightmares in the aftermath of trauma will prospectively predict later suicidal ideation, inde- pendent of comorbid insomnia. Methods: We recruited adults that were admitted to the intensive care unit at Henry Ford Hospital in Detroit after experiencing a DSM-5 Criterion A traumatic event (N = 76, Mage = 38.39, 65.8% male). Participants completed study surveys at three time points: T1 (an average of 6 days after trauma), T2 (two weeks after T1), and T3 (1 month after T1). Nightmare and insomnia severity were measured at T2 with the Nightmare Disorder Index (NDI) and Insomnia Severity Index (ISI), respectively. Suicidal ideation was measured at T3 using item nine on the Patient Health Questionnaire (PHQ-9). Results: More severe nightmares in the acute aftermath of trauma (T2) predicted more severe SI two weeks later at T3 (β = 0.49, SE = .17, p = .004, R2 = .22). This association remained even after adjusting for T1 SI, T2 ISI, age, and sex (β = 0.36, SE = .18, p = .044, R2 = .31). Conclusion: More severe nightmares in the acute aftermath of trauma predicted more severe SI one month after trauma, independent of comorbid insomnia symptoms and baseline sui- cidal ideation. These findings suggest that the onset of night- mares immediately after trauma may confer a unique risk for SI. In clinical practice, it may be useful to detect nightmares in the aftermath of trauma using brief measures such as the NDI. Trauma survivors that develop frequent and severe nightmares within the acute recovery phase could then be given targeted nightmare treatment to reduce the risk of later SI. Support (if any): Abstract citation ID: zsad077.0660 0660 IDENTIFYING PATIENTS AT RISK OF ACUTE SLEEP DISTURBANCES WITHIN THE IMMEDIATE AFTERMATH OF TRAUMA Anthony Reffi 1 , David Kalmbach 1 , Grace Seymour 1 , Alec Bayoneto 1 , Chaewon Sagong 1 , Christopher Drake 1 1 Henry Ford Health Introduction: Acute sleep disturbances are a common, modifia- ble consequence of trauma that, if left untreated, increase risk of PTSD by nearly two-fold. This suggests acute sleep disturbances after trauma are an important contributor to the etiology of PTSD that could be targeted early to prevent the disorder. Yet, effective strategies to prevent PTSD cannot currently be imple- mented because we cannot identify who is most at risk of acute sleep disturbances after trauma, thus obstructing the ability to identify high-risk groups in need of early intervention. This study will test sleep reactivity – a trait predisposition to expe- rience sleep disturbances after stress – as a predictor of post- traumatic sleep disturbances within one month following trauma exposure. Methods: We recruited patients admitted to Henry Ford Hospital’s intensive care unit in Detroit for traumatic injury (e.g., gunshot wound) (N = 88, M age = 39.53, SD = 14.31). While hospitalized, patients reported their pre-trauma sleep reactivity (Ford Insomnia Response to Stress Test; FIRST) and insomnia symptoms from the past two weeks (Insomnia Severity Index; ISI). Patients then completed the ISI again one month later (n = 48). We tested high sleep reactivity (FIRST > 21) as a prospective predictor of clinically significant posttraumatic sleep disturbances (ISI > 10). Results: Patients were mostly black men (67%), and nearly half reported an annual income < $20,000 (47.7%). Motor vehi- cle collisions were the most common trauma that precipitated patients’ hospital admission (42%), followed by assaults with a weapon (30.7%). While adjusting for age and pre-trauma sleep disturbance, high sleep reactivity predicted increased odds of sleep disturbances one month after trauma (b = 2.08, SE = .98, p = .033, OR = 8.01, CI = 1.19 – 54.15). Conclusion: Individuals with high sleep reactivity are at increased susceptibility of clinically significant sleep disturbances after trauma. The 9-item FIRST is a brief and clinically useful indica- tor that offers providers the ability to predict the onset of acute sleep disturbances after trauma, which are novel targets for early intervention. This might enable the early identification of poten- tially vulnerable individuals who might develop PTSD, toward whom sleep-focused preventive efforts can be targeted. Support (if any): Abstract citation ID: zsad077.0661 0661 NATURAL HISTORY OF NIGHTMARES FROM CHILDHOOD TO YOUNG ADULTHOOD: A LONGITUDINAL, POPULATION-BASED STUDY Raegan Atha 1 , Caitlin Paquet 2 , Susan Calhoun 2 , Fan He 1 , Alexandros Vgontzas 3 , Jason Liao 1 , Edward Bixler 1 , Duanping Liao 1 , Julio Fernandez-Mendoza 1 1 Penn State College of Medicine, 2 Penn State Hershey Medical Center, 3 Pennsylvania State University, College of Medicine Introduction: Nightmares are common in childhood and typ- ically become less prevalent in adulthood. However, little is known about the natural course of nightmares as children grow into adulthood. The purpose of this study was to examine the longitudinal trajectory of nightmares from childhood to adult- hood to determine population-based remission, incidence, and persistence rates. Methods: The Penn State Child Cohort is a random, popula- tion-based sample of 700 children (5-12 years at baseline) who returned for follow-up visits during adolescence and young adulthood. For the current study, 258 young adults (25.1±2.7 B. Clinical Sleep Science and Practice V. Sleep and Psychiatric Disorders Downloaded from https://academic.oup.com/sleep/article/46/Supplement_1/A290/7182377 by guest on 31 May 2023