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Introduction and objectives Sleep-disordered breathing, particularly obstructive sleep apnoea (OSA), is associated with physical morbidity, psychosocial impairment and economic cost; yet patient-reported burden at diagnosis is seldom captured in routine care. We therefore surveyed adults with newly diagnosed OSA to: (i) determine the prevalence and perceived severity of core symptoms; (ii) quantify their impact across ten physical, mental and social quality-of-life domains; and (iii) establish the frequency of co-existing depressive and anxiety symptoms.Methods Consecutive adult patients with newly diagnosed OSA at a single-centre sleep service were invited to complete a questionnaire prior to commencing CPAP treatment (Oct 2023-Mar 2024). Four domains were evaluated: severity of OSA symptoms; quality-of-life domain (10-point Likert scale, 10=most affected), depression (PHQ-9); and anxiety (GAD-7).Results Seventy-two patients participated over a 6-month study period. They were predominantly male (58%); 49% identified as White British and 18% as Black African/Caribbean. The most prevalent symptoms of at least moderate severity were daytime low energy (81%), unrefreshing sleep (79%) and snoring (78%). The most affected life-domains were physical health (6.9±2.67), followed by mental health (6.5±3.13) and exercise (6.3±3.04). Finances (4.1±3.17) and independent living (3.8±3.32) were least affected ( figure 1). Elevated depression and anxiety scores (PHQ-9 ≥ 10 and GAD-7 ≥ 10) were observed in 55% and 33% of patients, respectively. At the item level, loss of interest (75%) and low mood (66%) were reported on ≥ ‘several days’, and 15/72 (21%) acknowledged self-harm thoughts. Anxiety items were positive on ≥ ‘several days’ in 59–74% of respondents.Abstract P56 Figure 1Conclusions This study shows that patients with OSA can experience marked multidimensional burden. Four in five experience moderate-to-severe fatigue or unrefreshing sleep, physical-health impact scores are highest, and exercise (mean 6.3) and family life (6.0) are similarly compromised. More than half screen positive for clinically relevant depression or anxiety. Routine assessments should incorporate validated patient-reported outcome measures for fatigue, functional limitation and mood, providing clear targets for counselling and follow-up.