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Idiopathic hypersomnia (IH) is relatively rare and characterized by excessive daytime sleepiness despite prolonged and undisturbed sleep as well as the absence of cataplexy and other causes of hypersomnolence. The etiology of IH is largely unknown. The present study capitalized on electronic medical record (EMR) data from the Veterans Health Administration (VHA) to create a cohort of veterans diagnosed with IH in order to: 1) estimate the prevalence of IH diagnosis in the VHA, and 2) identify co-occurring physical and behavioral health conditions to characterize IH in the sample. Methods Using 2009–19 VHA EMR data, we created two cohorts: those with an IH diagnosis (N = 3,674) or a hypersomnia diagnosis (e.g., primary hypersomnia) other than IH (N = 110,530). Diagnostic data (i.e., ICD 9 and 10 codes) were extracted for the 6-months prior to index diagnosis to examine group differences in the prevalence of physical and behavioral health conditions. Results Veterans diagnosed with IH, as compared to veterans with another hypersomnia disorder, were more likely to be female (30.1% vs 12.3%) and less likely to be obese (16% vs 28.3%; chi-squared = 79.27, p &amp;lt;.001), or carry diagnoses of diabetes (type 1 or 2; 9.7% vs 24.4%; chi-squared = 123.02, p &amp;lt;.001), or anxiety disorders (5.8% vs 9.5%; chi-squared = 16.83, p &amp;lt;.001). Individuals with IH were more likely to carry diagnoses of chronic fatigue syndrome (4.2% vs 1.6%; chi-squared = 45.91, p &amp;lt;.001), depression (31.3% vs 23.4%; chi-squared = 36.04, p &amp;lt;.001), and posttraumatic stress disorder (29.5% vs 26.5%; chi-squared = 5.79, p = .02). Conclusion Data suggest that veterans diagnosed with idiopathic hypersomnia may present with different diagnostic profiles than veterans with other hypersomnia disorders. Far more basic and clinical research is needed in IH. Support (if any) This work was supported by the Hypersomnia Foundation and in part by the VA Center of Excellence for Suicide Prevention in the Finger Lakes Healthcare System.

502 Idiopathic hypersomnia and co-occurring psychopathology among veterans