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

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  • Taylor, Shannon S
    • Other Affiliation: University of South Carolina School of Medicine Greenville, 607 Grove Rd, Greenville, SC 29605, USA
  • Hughes, Jaime M
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA
  • Coffman, Cynthia J
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Medicine, Durham, NC, USA
  • Jeffreys, Amy S
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA
  • Ulmer, Christi S
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Medicine, Durham, NC, USA
  • Oddone, Eugene Z
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Medicine, Durham, NC, USA
  • Bosworth, Hayden B
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Medicine, Durham, NC, USA
  • Yancy, William S., Jr.
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Medicine, Durham, NC, USA
  • Allen, Kelli D
    • Other Affiliation: Durham VA Health Care System, VA Medical Center (152), 508 Fulton Street, Durham, NC 27705, USA
Abstract
  • 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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  • Article
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  • In Copyright
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  • The Author(s).
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  • English
Bibliographic citation
  • BMC Musculoskeletal Disorders. 2018 Mar 09;19(1):79
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  • BioMed Central

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