0996 A New Insomnia Phenotype: Coronasomnia Misophonia Syndrome

Abstract Introduction Misophonia is a complex neuropsychiatric phenomenon characterized by an intense selective auditory hypersensitivity to stimuli accompanied emotional intolerance consisting of anger, anxiety, and frustration. We report on four subjects who presented with significant sleep onset insomnia coinciding the mandated stay-at-home order in March 2020. All patients reported unique specific irritability aversion sounds their proximal environment - misophonic trigger (MT). While previous study capacity misophonia emerge during venerable periods confinement, we series whom was precipitant insomnia, “misophonic response” hypervigilance insomnia. Our findings support consideration phenotype Coronasomnia Syndrome (CMS). Report case(s) Subject A 29-year-old female history OCD mild (MT: humming refrigerator). B 31-year-old delayed phase disorder her teenage years husband’s breathing). C 36-year-old male well-controlled sleep-onset electric from walls). D 46-year-old depression carotid pulsation transmitted through his pillow). but one patient had reasonable improvement mindfulness therapy combined systematic desensitization. improved after pharmacological modification therapy. Conclusion case supports CMS as social isolation COVID-19 pandemic. The MT might have served classical conditioning. Desensitization helpful, presence comorbid led refractory course supporting pervasive sensory processing this patient. data highlights need for more dedicated investigation presenting times confinement unprecedented anxiety. Additional needed our observation investigate potential psychophysiological mechanism, particularly proposed alteration response healthy psychiatric cohorts. Support (if any)