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

dc.contributor.author

Taylor, Shannon Stark

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Hughes, Jaime M

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Coffman, Cynthia J

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Jeffreys, Amy S

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Ulmer, Christi S

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Oddone, Eugene Z

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Bosworth, Hayden B

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Yancy, William S

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Allen, Kelli D

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2024-01-26T15:33:35Z

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2024-01-26T15:33:35Z

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2018-03

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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 .
dc.identifier

10.1186/s12891-018-1993-y

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1471-2474

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1471-2474

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https://hdl.handle.net/10161/29887

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eng

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Springer Science and Business Media LLC

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BMC musculoskeletal disorders

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10.1186/s12891-018-1993-y

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https://creativecommons.org/licenses/by-nc/4.0

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Humans

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Osteoarthritis, Knee

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Osteoarthritis, Hip

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Sleep Apnea, Obstructive

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Sleep Initiation and Maintenance Disorders

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Polysomnography

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Prevalence

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Cross-Sectional Studies

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Aged

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Middle Aged

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Veterans

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Female

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Male

dc.title

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

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Journal article

duke.contributor.orcid

Hughes, Jaime M|0000-0001-6410-0068

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Coffman, Cynthia J|0000-0002-4554-1463

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Ulmer, Christi S|0000-0002-3512-4252

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

pubs.begin-page

79

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1

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Duke

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School of Medicine

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Faculty

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Biostatistics & Bioinformatics

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Medicine

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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Center for the Study of Aging and Human Development

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Initiatives

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Duke Science & Society

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Population Health Sciences

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

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Duke - Margolis Center For Health Policy

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Biostatistics & Bioinformatics, Division of Biostatistics

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Published

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19

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