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Obstructive Sleep Apnea and Pain Intensity in Young Adults.

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.


OBJECTIVE
This study aims to examine whether young adults who are diagnosed with OSA are more likely to report higher pain intensity compared to those without OSA.


METHODS
We conducted a cross-sectional analysis of a cohort study of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) 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 ICD-9 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 (BMI), 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 years [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. Compared to young adults without OSA, those with OSA were more likely to report moderate/severe pain intensity (OR=1.09; 95% Confidence Intervals 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. Due to 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.