Investigando a associação entre o risco de apneia obstrutiva do sono, sonolência excessiva diurna, qualidade de sono, dor e incapacidade em idosos com dor lombar crônica

Abstract

Introduction: Chronic low back pain (CLBP) and obstructive sleep apnea (OSA) associated with excessive daytime sleepiness (EDS) are health conditions prevalent in older adults. Considering the bidirectional relationship between sleep problems and pain, it is possible that older adults CLBP and OSA have greater pain intensity and disability. Objectives: (1) to investigate associations between the risk of OSA, EDS, pain intensity and disability in older adults with CLBP. Methods: Cross-sectional observational study, carried out with older adults aged 60 years or older, of both sexes, with CLBP and who sought care in a Primary health care setting in Belo Horizonte. In addition to sociodemographic data, information was collected on risk for OSA (Berlin Questionnaire), excessive daytime sleepiness (Epworth Sleepiness Scale), sleep quality (Pittsburgh Sleep Quality Index), CLBP intensity (Numeric Rating Scale), disability (Roland Morris Disability Questionnaire), depressive symptoms (Geriatric Depression Scale) and sleep complaints (Sleep Complaints Questionnaire). Descriptive analysis was expressed as mean, standard deviation and percentage. The main analysis comprised the execution of 6 simple linear regression models and 6 multivariable linear regression models, adjusted for 6 covariates (potential confounders). Results: A total of 100 older adults, mean age of 69.8 (±6.6) years, 69% female, were included. Univariate linear regression analysis showed an association between the risk of OSA and the pain intensity [(0.30 (95% CI: 0.16 to 0.72)], but this was not supported by the multivariate analysis. The OSA showed an association with disability in the univariate linear analysis [0.33 (95% CI: 0.20 to 0.75)], but not in the multivariate analysis. The EDS showed no association with the pain intensity in the univariate linear analysis, but there was a negative association with pain intensity in the multivariate analysis [-0.21 (95% CI: -0.42 to 0.01)]. 34 (CI 95%: 0.15 to 0.53)], but which did not occur in the multivariate analysis. Sleep quality was associated with pain intensity in the linear univariate analysis [0.28 (CI 95%: 0. 09 to 0.47)], but the same did not occur in the multivariate analysis. Sleep quality was associated with disability, both in the univariate linear analysis [0.54 (95% CI: 0.37 to 0.71)] how much multivariate [0.25 (95% CI: 0.07 to 0.43)]. Ninety-six percent (96%) of the older adults, had at least one sleep complaint, the most prevalent being nocturnal awakening (76%). Conclusion: Among the studied variables, the quality of sleep showed a greater association with disability. Furthermore, we found a high prevalence of sleep complaints in older adults with CLBP.