Because of the high burden of chronic pain conditions in younger adults this study highlights the need to understand the impact of OSA diagnosis and treatment on pain intensity researchers led by Wardah Athar a graduate student at Yale University New Haven Conn and Lori A Bastian MD MPH a professor of internal medicine at Yale wrote in an article published in the Annals of the American Thoracic Society This understanding would then help inform the development of interventions to promote screening for OSA among young adults with chronic pain and pain management among those with diagnosed OSA
In an effort to assess whether young adults with diagnosed OSA are more likely to report higher pain intensity compared with those without OSA the researchers drew from a sample of 858226 veterans from Operation Enduring Freedom Operation Iraqi Freedom and Operation New Dawn who had at least one visit to a VA clinic between 2001 and 2014 They used ICD 9 codes to identify OSA and assessed self reported responses to pain measures on a 0 10 numeric scale which were recorded in each veterans EMR Next they averaged pain intensity responses over a 12 month period and categorized them as none 0 mild 1 3 and moderatesevere 410 Covariates included age sex education race mental health diagnoses headache diagnoses pain diagnoses hypertension diabetes body mass index and smoking status The researchers used multivariate logistic regression models and multiple imputation to generate values for missing variables
The mean age of the patients was 30 years 64 were White 17 were Black 12 were Hispanic and remainder were otherunknown raceethnicity Ninety percent were male and 20 had greater than a high school education Of the 858226 patients 91244 11 had a diagnosis of OSA Compared with patients who had no diagnosis of OSA the unadjusted odds of reporting moderatesevere pain was 48 higher among those with OSA odds ratio 148 P < 0001 After the researchers adjusted for all covariates in the model the association between OSA and moderatesevere pain remained significant though attenuated with an adjusted odds ratio of 109 P < 0001
Several characteristics were different between those who had a diagnosis of OSA and those who did not including age a mean of 36 vs 26 years respectively and having the following diagnoses pain 36 vs 16 headache 28 vs 14 diabetes 12 vs 2 hypertension 40 vs 12 and a body mass index of 30 kgm2 or greater 69 vs 35 Certain psychiatric disorders were also common among patients with OSA including major depressive disorder 20 vs 10 posttraumatic stress disorder 50 vs 30 and substance use disorder 26 vs 17 Patients with OSA were also more likely to have been prescribed benzodiazepines or opioids within 90 days of their OSA diagnosis Although men were more likely to have a diagnosis of OSA no differences related to sex in the association of OSA and pain were observed in sex based stratified analyses
Based on these results we suggest more thorough and more frequent pain intensity screening in patients with OSA particularly in those patients who are younger than 60 years old without significant comorbid illness the researchers concluded Furthermore we also recommend increased OSA screening for patients with moderatesevere pain intensity and pain diagnoses One tool they recommend is the STOP Bang Snoring Tiredness Observed Apnea Blood Pressure Body Mass Index Age Neck Circumference and Gender questionnaire which has been validated in multiple settings
What those in pain can do to promote better sleep
Quality sleep is often an indicator of ones overall health and quality of life Therefore it is important for those with and even without pain to make sleep a priority
Some of the things that nearly everybody should attempt is to practice better sleep hygiene Sleep hygiene is a set of practices and habits that help promote better sleep They include sleep friendly things like getting exercise exposing oneself to light at certain times of the day eating sleep promoting foods practicing relaxation techniques before bed and making sure that the sleep environment is aimed at promoting quality sleep
Another important thing to do is to make sure that other factors such as sleep disoders including sleep apnea restless leg syndrome and others arent also contributing to sleep loss Your doctor may recommend having a sleep study performed to rule out any number of sleep disorders that may be contributing to your sleep loss before concluding that the pain is solely responsible for your sleep problems
The reason many doctors will first want to address the sleep environment and possible sleep disorders as contributing to sleep loss is because sleep medications can often interact with pain medications in a potentially dangerous way In many cases it is much more likely that a doctor will recommend changing your sleep habits before prescribing more medications
Simply having a higher motivation to make sleep a priority even for those in pain can increase the quantity and quality of sleep The best thing a person can do that is having sleep troubles is to take control of their sleep by giving it precedence in their life
If you live in Alaska and your doctor recommends that you have a sleep study to rule out sleep disorders contact the Alaska Sleep Clinic to receive a free 10 minute phone consultation with a sleep professional
