BackgroundAxial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) may have a profound impact on health-related quality of life (HRQoL) and sleep despite effective treatment.ObjectivesTo assess sleep and HRQoL in SpA and determine associated factors.MethodsMonocentric questionnaire-based assessment of HRQoL, function, sleep and depression in 314 SpA patients (n=168 PsA, n=146 axSpA).ResultsUnder effective treatment 138 SpA patients (46.5%) demonstrated abnormal sleep behaviour. 49.3% reported not being able to sleep through the night, with 6.1 % needing sleeping pills. 11.9% indicated feeling unrefreshed most mornings. Abnormal sleep behaviour was associated with female sex (p=0.005), HLAB27 (p=0.034), functional impairment (p=0.001) and depression (pConclusionDespite treatment many SpA patients have a reduced HRQoL and impaired sleep quality with significant differences between male and female patients. Impact of COVID19 pandemic was low.Table 1.Patient characteristicsTotal (n=314)Women n=142 (45.2%)Men n=172 (54.8%)p-valueAge, years, mean (SD)53.8 (13.9)53.7 (14.5)53.8 (13.4)0.983BMI, kg/m2, mean (SD)27.3 (6.3)27.1 (6.5)27.4 (6.1)0.706Smokers, n (%)68 (23.1)34 (24.6)34 (21.7)0.544HLA B27, n (%) (n=230)120 (52.2)46 (45.1)54 (54.9)0.055CRP, mg/l, mean (SD)6.14 (11.9)5.88 (6.0)6.37 (15.2)0.721Significant functional impairment, n (%)54 (17.5)29 (20.6)25 (15.0)0.198Therapy, n (%) csDMARD113 (36.2)56 (39.7)57 (33.3)0.243 bDMARD211 (67.4)91 (64.1)120 (70.2)0.252Depressive symptoms, n (%) Mild109 (37.5)53 (39.3)56 (35.9)0.040 Moderate/severe48 (16.5)27 (20.0)21 (13.5)WHO-QOL mean (SD) Physical60.2 (19.4)57.4 (19.7)62.6 (19.0)0.019 Mental67.7 (17.2)64.5 (17.8)70.3 (16.2)0.003 Social67.8 (20.0)67.4 (19.6)68.2 (20.3)0.703 Environmental77.3 (13.3)76.6 (13.6)78.0 (13.1)0.363Sleep, n (%) Abnormal sleep behaviour138 (46.5)76 (55.1)62 (39.0)0.006 Inability to sleep through the night145 (49.4)76 (55.1)69 (44.2)0.024 Waking too early89 (30.4)43 (31.4)46 (29.5)0.459 Need for sleeping pills18 (6.1)11 (8.0)7 (4.4)0.133 Unrefreshing sleep most or all nights35 (11.9)24 (17.5)11 (7.0)Figure 1.Female SpA patients have increased depressive symptoms and a reduced HRQoL.Disclosure of InterestsNatalie Frede Grant/research support from: Novartis study grant, Eva Rieger: None declared, Raquel Lorenzetti Grant/research support from: Novartis study grant, Ana Venhoff: None declared, Carolin Hentze: None declared, Ilona Jandova: None declared, Cornelia Glaser: None declared, Jens Thiel Speakers bureau: Novartis, AbbVie, Pfizer, BMS, UCB, Consultant of: Novartis, AbbVie, Pfizer, BMS, UCB, Grant/research support from: BMS, Novartis study grants, Reinhard Voll Speakers bureau: Novartis, AbbVie, Pfizer, BMS, UCB, Consultant of: Novartis, AbbVie, Pfizer, BMS, UCB, Lilly, Grant/research support from: Novartis study grant, Nils Venhoff Speakers bureau: Novartis, AbbVie, Pfizer, BMS, UCB, Consultant of: Novartis, AbbVie, Grant/research support from: Novartis study grant