Nature and Science of Sleep (Nov 2022)

Subjective Sleep Disruption and Mood Disorders are Associated with the Risk of Chronic Pain in Patients with Obstructive Sleep Apnea

  • Liu L,
  • Li X,
  • Xue P,
  • Wu M,
  • Zeng S,
  • Dai Y,
  • Zhou J

Journal volume & issue
Vol. Volume 14
pp. 2023 – 2032

Abstract

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Liu Liu1 *, Xiao Li2,3 *, Pei Xue,4 Min Wu,4 Si Zeng,1 Yuee Dai,1 Junying Zhou4,5 1Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 2Department of Psychology, Sleep Research Clinic and Laboratory, the University of Hong Kong, Hong Kong Special Administrative Regions, People’s Republic of China; 3State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong Special Administrative Regions, People’s Republic of China; 4Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 5Department of Neurology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Junying Zhou, Sleep Medicine Center, West China Hospital, Sichuan University, 28 Dian Xin Nan Jie, Chengdu, Sichuan Province, People’s Republic of China, Email [email protected]: This study aimed to determine the prevalence of chronic pain and its risk factors in patients with obstructive sleep apnea (OSA).Methods: A total of 145 patients diagnosed with OSA were consecutively recruited from the Sleep Medicine Center in West China Hospital. All patients were divided into two groups including OSA with and without chronic pain. They were assessed the subjective sleep (Pittsburgh Sleep Quality Index, Insomnia Severity Index), objective sleep (polysomnography), mood symptoms (Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale), and pain characteristics (Short-Form McGill Pain Questionnaire). Demographic, clinical, subjective and objective sleep parameters were compared between OSA patients with and without chronic pain. Binary logistic regression models and linear regression models were used to examine the risk factors of chronic pain in OSA.Results: Fifty-five (37.9%) patients with OSA were diagnosed with chronic pain. There were more severe subjective sleep disruption and symptoms of anxiety and depression in patients with chronic pain compared to those without chronic pain. After controlling for potential confounders, poor subjective sleep quality and severe insomnia and mood disorders (all ps 0.05) were associated with the increased risk of pain and pain intensity, respectively.Conclusion: More than one-third of patients with OSA had chronic pain. Subjective sleep disruption and mood disorders are the risk factors of chronic pain in OSA. Our findings suggest that subjective sleep quality should be valued highly in the relationship between OSA and pain.Keywords: obstructive sleep apnea, subjective sleep disruption, insomnia, anxiety, depression, chronic pain

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