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The Association of Obstructive Sleep Apnea and Pain Outcomes in Adults: A Systematic Review

机译：梗阻性睡眠呼吸暂停和成人疼痛结果的关联：系统审查

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Objective. The specific link between obstructive sleep apnea (OSA) and pain is unknown, but it has been hypothesized that OSA patients are hyperalgesic because of fragmented sleep and hypoxemia that enhance sensitivity to pain, promote inflammation, and increase spontaneous pain. We conducted a systematic review of the literature assessing whether OSA is a risk factor for subjective pain intensity and experimental pain tolerance and threshold. Design/Participants. A search of published studies in English in MEDLINE, PubMed, Embase, and the Cochrane Database of Systematic Reviews from database inception through May 2017 was performed. Search terms included "sleep apnea," "continuous positive airway pressure," "CPAP," "pain," and "chronic pain." Methods. We included any study that reported an association between OSA or polysomnogram assessments with pain outcomes or reported the effect of CPAP on pain outcomes. Controlled studies, cohort studies, and case-control studies were included. Results. We identified 448 studies from PubMed and 959 studies from Embase, giving a combined 1,333 studies after removing duplicates. After detailed selection, 28 articles were reviewed in full and 12 met study inclusion criteria. Whereas several studies found an association between OSA and pain intensity or experimental pain, there was considerable variability among study outcomes. Delivery of CPAP may improve pain and decrease opioid use, although the exact nature of the relationship between pain and the various pathophysiologic components of OSA is unclear. Conclusions. This systematic review summarizes the current evidence for the association of OSA and pain outcomes. Further research is needed to identify the differential effects of nocturnal hypoxemia and fragmented sleep on pain intensity. Clinicians might consider screening patients with chronic pain for OSA.
机译：客观的。阻塞性睡眠呼吸暂停（OSA）和疼痛之间的特定联系是未知的，但已经假设OSA患者因缺钙和缺氧血症而增强对疼痛，促进炎症的敏感性，并增加自发性疼痛，因此患者是痛苦的。我们对评估OSA是否是主观疼痛强度和实验疼痛耐受性和阈值的危险因素的系统审查。设计/参与者。在Medline，PubMed，Embase和Cochrane数据库中搜索在Medline，PubMed，Embase和Cochrane数据库中搜索来自数据库成立于2017年5月的系统性评论中。搜索条款包括“睡眠呼吸暂停”，“连续正气道压，”CPAP，“疼痛，”和“慢性痛”。方法。我们包括任何研究报告OSA或多面组评估与疼痛结果之间的关联或报告CPAP对疼痛结果的影响。包括对照研究，队列研究和病例对照研究。结果。我们确定了448项从开发的Pubmed和959项研究的研究，在去除重复后，在删除后的1,333项研究。详细选择后，完整审查了28篇文章，12次符合研究纳入标准。虽然几项研究发现了OSA和疼痛强度或实验疼痛之间的关联，但研究结果之间存在相当大的变化。 CPAP的递送可能会改善疼痛和减少阿片类药物，尽管疼痛与OSA的各种病理学组分之间的关​​系的确切性质尚不清楚。结论。这种系统审查总结了OSA和疼痛结果的当前证据。需要进一步的研究来鉴定夜间缺氧血症和分散睡眠对疼痛强度的差异影响。临床医生可能会考虑筛查患者对OSA的慢性疼痛。

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