1020 Long-term Impact of Psilocybin Administration on Sleep-Continuity via Wearable Sensor Time-series: Preliminary-results in Post-Treatment Lyme Disease

Abstract Introduction Post-treatment Lyme Disease (PTLD) is a post-infectious syndrome characterized by fatigue, hypersomnia, sleep-disturbance, musculoskeletal pain and/or cognitive difficulties. As part of an open-label pilot study of psilocybin-assisted treatment for PTLD, we explored potential for psilocybin-assisted treatment to remedy sleep-related disturbances in this population. Methods 12 participants consented to undergo continuous sleep-monitoring using a non-intrusive consumer smart-ring, throughout an 8-week treatment protocol, which included two psilocybin sessions (15mg and 25mg at weeks 4 and 6, respectively), with follow-up assessments 1, 3, and 6 months after the final psilocybin session. Sleep data were captured continuously throughout the entire study period, beginning three weeks prior to the first dosing session. We obtained nightly estimates of Total Sleep Time (TST mins), which were modeled using Bayesian structural time-series (BSTS) models. Results BSTS models indicated a cumulative reduction in total sleep time (TST) following the first psilocybin session (-613 min; 95% Credible Interval: -1216 to -33), with a high posterior probability of a causal effect (97.9%). Following the second session, the cumulative reduction was smaller (-153 min; 95% Credible Interval: -458 to 165) and accompanied by greater uncertainty. Average causal effects across the post-session windows were -32 min (95% Credible Interval: -64 to -2) after session one and -17 min (95% Credible Interval: -51 to +18) after session two. However, the credible interval for session two spanned zero, indicating reduced certainty regarding both the presence and direction of the effect relative to session one. Conclusion Findings suggest a long-term reduction in actigraphy-TST following psilocybin administration that was maximal following the first dose. This decrease in actigraphy-TST could reflect a normalization of hypersomnia and excessive sleep drive typically observed in PTLD. Future work is required to further align these findings within the conceptual framework of PTLD symptomatology by examining whether these actigraphic estimates of sleep continuity align with participant-reports of sleep quality, and daytime somnolence. Support (if any) Work was supported by the Johns Hopkins Center for Psychedelic and Consciousness Research with funding provided by Tim Ferriss, Matt Mullenweg, Blake Mycoskie, Craig Nerenberg, and the Steven and Alexandra Cohen Foundation.