0836 Chronic Pain worsens Daytime Sleepiness, Insomnia and Quality of Life in Veterans with Obstructive Sleep Apnea

Abstract Introduction Chronic noncancer pain (CP) commonly co-occurs with obstructive sleep apnea (OSA) and may contribute to greater symptom burden. The study aim was to examine differences in sleepiness (Epworth Sleepiness Scale, ESS), insomnia symptoms (Insomnia Severity Index [ISI]), and quality of life (Short Form Health Survey 20, SF-20) in veterans with OSA with or without pre-existing CP. Methods An observational, cross-sectional, study of veterans with newly diagnosed, untreated OSA was conducted. Unadjusted between-group comparisons (i.e., OSA-only versus OSA + CP) were conducted using the Welch’s t-test and Pearson Chi-Square. Regression analyses were performed to determine the influence of self-reported CP on sleep-related symptoms and quality of life while controlling for potential confounders (i.e., age, sex, OSA severity, body mass index, percentage of total sleep time spent with SpO2 < 90%, and presence of psychiatric/mental health comorbidities). The Hochberg (step-up) method was used to control for the family-wise error rate at 5%. Results The final sample included N=111 participants with complete survey responses. Compared to the group with OSA-only (n=40), veterans with comorbid OSA and CP (n=71) experienced significantly higher ESS (12.7 ± 5.5 vs 10.2 ± 5.2; p = .021) and ISI scores (18.1 ± 6.2 vs. 13.7 ± 7.4; p = .002), and worse quality of life across all SF-20 domains. Of note, clinically significant insomnia (ISI score > 15) was most common among veterans with comorbid OSA and CP (68.7% vs. 45.5%, p = .010). In adjusted analyses, CP diagnosis was significantly associated with higher ESS (adjusted mean difference [95% CI] = 2.72 [0.55, 4.88], p = .014) and ISI scores (adjusted mean difference [95% CI] = 3.82 [1.27, 6.37], p =.004). Conclusion There is a high prevalence of CP among veterans with OSA and symptom burden is higher in patients with OSA and CP. Future investigations should address symptom response and burden to OSA treatment in comorbid OSA and CP to guide outcome expectancies and residual OSA symptom treatment plans. Support (if any) SRSF Small Research Grant Award: 05-SRG-20. University of Pennsylvania School of Nursing, Office of Nursing Research.