Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis

Abstract Background Few studies have examined patterns of specific sleep problems among individuals with osteoarthritis (OA). The primary objective of this study was to examine prevalence of symptoms of insomnia and obstructive sleep apnea (OSA) among Veterans with OA. Secondary objectives were to a...

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Main Authors: Shannon Stark Taylor, Jaime M. Hughes, Cynthia J. Coffman, Amy S. Jeffreys, Christi S. Ulmer, Eugene Z. Oddone, Hayden B. Bosworth, William S. Yancy, Kelli D. Allen
Format: Article
Language:English
Published: BMC 2018-03-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-018-1993-y
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author Shannon Stark Taylor
Jaime M. Hughes
Cynthia J. Coffman
Amy S. Jeffreys
Christi S. Ulmer
Eugene Z. Oddone
Hayden B. Bosworth
William S. Yancy
Kelli D. Allen
author_facet Shannon Stark Taylor
Jaime M. Hughes
Cynthia J. Coffman
Amy S. Jeffreys
Christi S. Ulmer
Eugene Z. Oddone
Hayden B. Bosworth
William S. Yancy
Kelli D. Allen
author_sort Shannon Stark Taylor
collection DOAJ
description Abstract Background Few studies have examined patterns of specific sleep problems among individuals with osteoarthritis (OA). The primary objective of this study was to examine prevalence of symptoms of insomnia and obstructive sleep apnea (OSA) among Veterans with OA. Secondary objectives were to assess proportions of individuals with insomnia and OSA symptoms who may have been undiagnosed and to examine Veterans’ characteristics associated with insomnia and OSA symptoms. Methods Veterans (n = 300) enrolled in a clinical trial completed the Insomnia Severity Index (ISI) and the Berlin Questionnaire (BQ) at baseline; proportions of participants with symptoms consistent with insomnia and OSA were calculated, using standard cut-offs for ISI and BQ. For Veterans with insomnia and OSA symptoms, electronic medical records were searched to identify whether there was a diagnosis code for these conditions. Multivariable linear (ISI) and logistic (BQ) regression models examined associations of the following characteristics with symptoms of insomnia and OSA: age, gender, race, self-reported general health, body mass index (BMI), diagnosis of post-traumatic stress disorder (PTSD), pain severity, depressive symptoms, number of joints with arthritis symptoms and opioid use. Results Symptoms consistent with insomnia and OSA were found in 53 and 66% of this sample, respectively. Among participants screening positive for insomnia and OSA, diagnosis codes for these disorders were present in the electronic medical record for 22 and 51%, respectively. Characteristics associated with insomnia were lower age (β (SE) = − 0.09 (0.04), 95% confidence interval [CI] = − 0.16, − 0.02), having a PTSD diagnosis (β (SE) = 1.68 (0.73), CI = 0.25, 3.11), greater pain severity (β (SE) = 0.36 (0.09), CI = 0.17, 0.55), and greater depressive symptoms (β (SE) = 0.84 (0.07), CI = 0.70, 0.98). Characteristics associated with OSA were higher BMI (odds ratio [OR] = 1.13, CI = 1.06, 1.21), greater depressive symptoms (OR = 1.12, CI = 1.05, 1.20), and opioid use (OR = 0.51, CI = 0.26, 0.99). Conclusions Insomnia and OSA symptoms were very common in Veterans with OA, and a substantial proportion of individuals with symptoms may have been undiagnosed. Characteristics associated with insomnia and OSA symptoms were consistent with prior studies. Trial registration NCT01130740.
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spelling doaj.art-21da625d374744b1909cf58d7c8c059b2022-12-22T01:22:15ZengBMCBMC Musculoskeletal Disorders1471-24742018-03-011911810.1186/s12891-018-1993-yPrevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritisShannon Stark Taylor0Jaime M. Hughes1Cynthia J. Coffman2Amy S. Jeffreys3Christi S. Ulmer4Eugene Z. Oddone5Hayden B. Bosworth6William S. Yancy7Kelli D. Allen8University of South Carolina School of Medicine GreenvilleDurham VA Health Care System, VA Medical Center (152)Durham VA Health Care System, VA Medical Center (152)Durham VA Health Care System, VA Medical Center (152)Durham VA Health Care System, VA Medical Center (152)Durham VA Health Care System, VA Medical Center (152)Durham VA Health Care System, VA Medical Center (152)Durham VA Health Care System, VA Medical Center (152)Durham VA Health Care System, VA Medical Center (152)Abstract Background Few studies have examined patterns of specific sleep problems among individuals with osteoarthritis (OA). The primary objective of this study was to examine prevalence of symptoms of insomnia and obstructive sleep apnea (OSA) among Veterans with OA. Secondary objectives were to assess proportions of individuals with insomnia and OSA symptoms who may have been undiagnosed and to examine Veterans’ characteristics associated with insomnia and OSA symptoms. Methods Veterans (n = 300) enrolled in a clinical trial completed the Insomnia Severity Index (ISI) and the Berlin Questionnaire (BQ) at baseline; proportions of participants with symptoms consistent with insomnia and OSA were calculated, using standard cut-offs for ISI and BQ. For Veterans with insomnia and OSA symptoms, electronic medical records were searched to identify whether there was a diagnosis code for these conditions. Multivariable linear (ISI) and logistic (BQ) regression models examined associations of the following characteristics with symptoms of insomnia and OSA: age, gender, race, self-reported general health, body mass index (BMI), diagnosis of post-traumatic stress disorder (PTSD), pain severity, depressive symptoms, number of joints with arthritis symptoms and opioid use. Results Symptoms consistent with insomnia and OSA were found in 53 and 66% of this sample, respectively. Among participants screening positive for insomnia and OSA, diagnosis codes for these disorders were present in the electronic medical record for 22 and 51%, respectively. Characteristics associated with insomnia were lower age (β (SE) = − 0.09 (0.04), 95% confidence interval [CI] = − 0.16, − 0.02), having a PTSD diagnosis (β (SE) = 1.68 (0.73), CI = 0.25, 3.11), greater pain severity (β (SE) = 0.36 (0.09), CI = 0.17, 0.55), and greater depressive symptoms (β (SE) = 0.84 (0.07), CI = 0.70, 0.98). Characteristics associated with OSA were higher BMI (odds ratio [OR] = 1.13, CI = 1.06, 1.21), greater depressive symptoms (OR = 1.12, CI = 1.05, 1.20), and opioid use (OR = 0.51, CI = 0.26, 0.99). Conclusions Insomnia and OSA symptoms were very common in Veterans with OA, and a substantial proportion of individuals with symptoms may have been undiagnosed. Characteristics associated with insomnia and OSA symptoms were consistent with prior studies. Trial registration NCT01130740.http://link.springer.com/article/10.1186/s12891-018-1993-yOsteoarthritisSleep disturbanceInsomniaObstructive sleep apneaChronic painVeterans
spellingShingle Shannon Stark Taylor
Jaime M. Hughes
Cynthia J. Coffman
Amy S. Jeffreys
Christi S. Ulmer
Eugene Z. Oddone
Hayden B. Bosworth
William S. Yancy
Kelli D. Allen
Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis
BMC Musculoskeletal Disorders
Osteoarthritis
Sleep disturbance
Insomnia
Obstructive sleep apnea
Chronic pain
Veterans
title Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis
title_full Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis
title_fullStr Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis
title_full_unstemmed Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis
title_short Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis
title_sort prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis
topic Osteoarthritis
Sleep disturbance
Insomnia
Obstructive sleep apnea
Chronic pain
Veterans
url http://link.springer.com/article/10.1186/s12891-018-1993-y
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