Abstracts of 4th International Congress of WASM & 5th Conference of CSS / Sleep Medicine 12, Suppl. 1 (2011) S1–S130 S5 intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice is given as a single treatment. TEEN SLEEP, MEDIA EXPOSURES, AND PHYSICAL ACTIVITY: RESULTS FROM THE 2007 AND 2009 YOUTH RISK BEHAVIOR SURVEYS Caris Fitzgerald 1 , Erick Messias 1 , Daniel Buysse 2 . 1 University of Arkansas for Medical Sciences, United States; 2 University of Pittsburgh Sleep Medicine Institute, United States Introduction and Objectives: To quantify the association between different media exposures, vigorous physical activity, and self-reported sleep time in teens. Materials and Methods: All Youth Risk Behavioral Surveys (YRBS) with sleep data were analyzed to produce a nationally representative sample of US high-school students (2007 N=14,041, 2009 N=16,410). Media exposure was evaluated with two questions on average school day use: “How many hours of TV do you watch?” and “How many hours do you play video or computer games or use a computer for something that is not school work?” Media exposure was dichotomized into light (1hr or less/day) or heavy (3hrs or more/day). Physical activity was assessed with the question “On how many of the past 7 days did you exercise or participate in physical activity for at least 20 minutes that made you sweat and breathe hard?” categorized as light (less then 3 days/week) or heavy (3 days or more/week). The outcome variable of self-reported sleep duration was assessed with the question: “On an average school night, how many hours of sleep do you get?” Logistic regression models were used to adjust for age, gender, race/ethnicity, presence of sadness, and substance abuse. Results: Compared to teens who reported sleeping 8 hrs/night, those re- porting 4 or less hrs/night of sleep were more likely to report heavy videogame/computer use (2007 adjusted odd ratio 2.3 (95% C.I. 1.7-3.0), 2009 2.0 (95% C.I. 1.5-2.6)) while being less likely to meet recommended physical activity levels (2007 0.7 (95% C.I. 0.6-0.9), 2009 0.5 (95% C.I. 0.4- 0.6)). TV exposure did not display significant associations with self-reported sleep in these samples. Conclusion: In these large samples of US teens, self-reported short sleep duration was associated with higher gaming/computer use, lower vigorous physical activity, and was unrelated to television watching. Acknowledgements: Center for Disease Control DEPRESSIVE SYMPTOMATOLOGY, MEDICATION PERSISTENCE, AND ASSOCIATED HEALTH CARE COSTS IN OLDER ADULTS WITH INSOMNIA Duru Golden Uzoma. Mon Oil and Gas Medical Clinic, Nigeria Introduction and Objectives: The effect of insomnia along with the de- creased cognitive functioning associated with aging is a serious concern within the elderly (65 years and older) population. We examined the as- sociation of patient health care utilization and depressive symtomatology with medication adherence in insomnia in Medicare-HMO enrolled elderly patients. Materials and Methods: This was a retrospective, longitudinal cohort study which included elderly patients (65 and older) enrolled continuously for 1-5 years in the Medicare HMO. Medication possession ratio was used to estimate the adherence in insomnia medication. Different MPR thresholds (0.8, 0.6, 0.4 and 0.2) were used to determine non adherence. Associations between depressive symptoms, medication adherence and health care costs were assessed using ordinary least square multiple regressions. Results: A total of 2068 patients with a primary diagnosis of insomnia were included in the study. Sixty percent of these patients had depressive symptomatology. The severity of comorbidity (Charlson index) was 4 and the patient perception of quality of life (Short Form-12 scores) were between 79 and 82. The prevalence of non adherence was 70% even with a low MPR of 0.2. Insomnia patients with depressive symptoms were 92% less likely to be adherent to their insomnia medications (p<0.05). After controlling other variables, we found MPR was a good predictor of total health care costs (10% increases in MPR for every 2% decrease in total health care costs, p<0.001) Conclusion: We found strong associations between depressive symtomatol- ogy, medication adherence, and health care costs in elderly patients with insomnia. Disease and risk management programs in managed care settings should be used to optimize the medication adherence in the elderly. Acknowledgements: Elisha Stephen MONTHLY FLUCTUATIONS OF SLEEP AND INSOMNIA SYMPTOMS OVER THE COURSE OF A YEAR IN A POPULATION-BASED SAMPLE Mélanie LeBlanc, Charles Morin, Lynda Bélanger, Hans Ivers, Marie-Andrée Côté. Université Laval, Canada Introduction and Objectives: The longitudinal course of insomnia is not well documented. Most studies examining temporal fluctuations of symp- toms have used yearly assessment intervals. The objective of this study was to document the course of insomnia symptoms and sleep quality by examining their fluctuations over shorter (i.e., monthly) intervals for one year. Materials and Methods: Participants were 100 adults (mean age = 49.9 years; 66% women) selected from a larger sample enrolled in a longitudinal study of insomnia. They completed 12 monthly telephone interviews as- sessing sleep and insomnia symptoms, use of sleep aids, stressful life events, and physical and mental health problems for the previous month. Of a potential 1200 interviews, 1121 (94.3%) were completed. Participants were classified in one of three groups based on data collected at each assessment: good sleepers (GS; n= 42 at baseline), insomnia symptoms (SYMP; n= 34 at baseline), and insomnia syndrome (SYND; n= 24 at baseline). Results: There were significant fluctuations of sleep/insomnia symptoms over time, with 66% of the participants changing status at least once over the 12 assessments (GS, 50%, SYND, 58.3%, and SYMP, 91.2%). On average, the sleep status of an individual changed 2.58 times over the 12 monthly assessments. Individuals with SYMP changed status significantly more fre- quently (3.41) than GS (1.93), but not more than SYND (2.54). Moreover, 83% of individuals with SYMP at baseline reported improved sleep (i.e., became GS) at least once over the year, compared to 29.4% who reported sleep worsening (i.e., became SYND). Among GS, risks of developing insomnia symptoms and syndrome over the subsequent months were respectively 14.4% and 3.2%. Conclusion: Repeated assessment of sleep and insomnia symptoms showed significant variability over monthly intervals. These findings highlight the importance of conducting assessment at shorter than the usual yearly interval in order to capture more reliably the course of insomnia over time. Acknowledgements: Research supported by Canadian Institutes of Health Research grant (#42504) COMPARATIVE EFFICACY OF BEHAVIOR THERAPY AND COGNITIVE THERAPY AS SINGLE THERAPIES FOR INSOMNIA: A PRELIMINARY REPORT Charles M. Morin 1 , Allison Harvey 2 , Lynda Bélanger 1 , Simon Beaulieu-Bonneau 1 , Émilie Fortier-Brochu 1 , Polina Eidelman 2 , Lisa Talbot 2 . 1 Université Laval, Canada; 2 University of California, United States Introduction and Objectives: Considerable evidence speaks for the efficacy of cognitive-behavior therapy (CBT) for insomnia. Yet, the unique contri- bution of its components remains poorly understood. This presentation summarizes preliminary results from a randomized controlled trial assess- ing the relative efficacy and contribution of cognitive therapy (CT) and behavior therapy (BT), compared to full CBT, for improving nighttime sleep and daytime functioning. Materials and Methods: 186 adults with chronic insomnia were recruited. This report comprises the first 100 participants (63% women; age = 38.8 years, insomnia duration = 12.8 years). They were randomly assigned to one of three 8-week treatment conditions: BT (n=32), CT (n=33), or CBT (n=35). Main end points were insomnia severity, measured by the Insomnia Severity Index (ISI), completed at baseline, mid, and end of treatment, and remission defined as an ISI score below 8. Results: Between-group differences were assessed using mixed model anal- yses. A significant interaction effect was observed for insomnia severity. Simple effects for treatment conditions were significant only at post- treatment (p=0.003). Pairwise comparisons revealed significant differences between CBT (M=6.58) and the other conditions (M=9.46 for each), p=0.0007, but there was no significant difference between BT and CT. Remission rates were also significantly different at post-treatment, F(2,79) = 4.34, p=0.02; there was a higher remission rate in CBT (72.4%) relative to CT (33.3%) and