TY - JOUR
T1 - Obstructive Sleep Apnea and Pain Intensity in Young Adults
AU - Athar, Wardah
AU - Card, Mary E.
AU - Charokopos, Antonios
AU - Akgü, Kathleen M.
AU - Derycke, Eric C.
AU - Haskell, Sally G.
AU - Yaggi, Henry K.
AU - Bastian, Lori A.
N1 - Funding Information:
Supported by the Office of Research and Development and Health Services Research and Development in the Department of Veterans Affairs of the Veterans Health Administration (IIR 12-118 and CIN 13-407), the Yale School of Medicine Medical Student Fellowship, and the U.S. National Institutes of Health (award T35HL007649).
Publisher Copyright:
© 2020 American Thoracic Society. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - Rationale: Prior research studies on the association of obstructive sleep apnea (OSA) and pain intensity have examined older patients; there is a need to understand the relationship between OSA and pain intensity among younger adults. Objectives: To examine whether young adults with diagnosed OSA are more likely to report higher pain intensity compared with those without OSA. Methods: We conducted a cross-sectional analysis of a cohort study of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans who had at least one visit to a Veterans Health Administration primary care clinic between 2001 and 2014. OSA was identified using one inpatient or two outpatient International Classification of Diseases, Ninth Revision codes from electronic medical records. Average pain intensity (based on the self-reported 0-10 numeric rating scale over a 12-month period) was categorized as no pain/mild (0-3; no pain) and moderate/severe (4-10; significant pain). Covariates included age, sex, education, race, mental health diagnoses, headache diagnoses, pain diagnoses, hypertension, diabetes, body mass index, and smoking status. Multivariate logistic regression models were used, and multiple imputation was performed to generate values for missing variables. Results: We identified 858,226 young adults (mean age 30 yr [SD= 7]), of whom 91,244 (10.6%) had a diagnosis of OSA and 238,587 (27.8%) reported moderate/severe pain for the 12-month average. with young adults without OSA, those with OSA were more likely to report moderate/severe pain intensity (adjusted odds ratio, 1.09; 95% confidence interval, 1.08-1.11) even after controlling for covariates. Conclusions: We found that young adults with OSA have greater odds of comorbid moderate/severe pain. Because of the high prevalence of chronic pain in younger adults, this study highlights the need to understand the impact of OSA diagnosis and treatment on pain intensity. Future work is needed to determine the role of effective OSA treatment on pain intensity over time in these young adults.
AB - Rationale: Prior research studies on the association of obstructive sleep apnea (OSA) and pain intensity have examined older patients; there is a need to understand the relationship between OSA and pain intensity among younger adults. Objectives: To examine whether young adults with diagnosed OSA are more likely to report higher pain intensity compared with those without OSA. Methods: We conducted a cross-sectional analysis of a cohort study of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans who had at least one visit to a Veterans Health Administration primary care clinic between 2001 and 2014. OSA was identified using one inpatient or two outpatient International Classification of Diseases, Ninth Revision codes from electronic medical records. Average pain intensity (based on the self-reported 0-10 numeric rating scale over a 12-month period) was categorized as no pain/mild (0-3; no pain) and moderate/severe (4-10; significant pain). Covariates included age, sex, education, race, mental health diagnoses, headache diagnoses, pain diagnoses, hypertension, diabetes, body mass index, and smoking status. Multivariate logistic regression models were used, and multiple imputation was performed to generate values for missing variables. Results: We identified 858,226 young adults (mean age 30 yr [SD= 7]), of whom 91,244 (10.6%) had a diagnosis of OSA and 238,587 (27.8%) reported moderate/severe pain for the 12-month average. with young adults without OSA, those with OSA were more likely to report moderate/severe pain intensity (adjusted odds ratio, 1.09; 95% confidence interval, 1.08-1.11) even after controlling for covariates. Conclusions: We found that young adults with OSA have greater odds of comorbid moderate/severe pain. Because of the high prevalence of chronic pain in younger adults, this study highlights the need to understand the impact of OSA diagnosis and treatment on pain intensity. Future work is needed to determine the role of effective OSA treatment on pain intensity over time in these young adults.
KW - Headache
KW - Pain intensity
KW - Sleep apnea
KW - Veterans
UR - http://www.scopus.com/inward/record.url?scp=85092680558&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092680558&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.201910-750OC
DO - 10.1513/AnnalsATS.201910-750OC
M3 - Article
C2 - 32644865
AN - SCOPUS:85092680558
SN - 2329-6933
VL - 17
SP - 1273
EP - 1278
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 10
ER -