Evidence map›Paper›PMID 34021465›Full record

SynthesisSleep & breathing = Schlaf & Atmung2022

Positive airway pressure therapy for chronic pain in patients with obstructive sleep apnea-a systematic review.

Kristian McCarthy, Aparna Saripella, Janannii Selvanathan, Mahesh Nagappa, Marina Englesakis, David Wang, Philip Peng, Frances Chung

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Sleep & breathing = Schlaf & Atmung, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Kristian McCarthyDepartment of Anesthesiology and Pain Management, Toronto Western Hospital, University Health Network, MCL 2-405, 399 Bathurst St, Toronto, M5T 2S8, ON, Canada.
Aparna SaripellaDepartment of Anesthesiology and Pain Management, Toronto Western Hospital, University Health Network, MCL 2-405, 399 Bathurst St, Toronto, M5T 2S8, ON, Canada.
Janannii SelvanathanDepartment of Anesthesiology and Pain Management, Toronto Western Hospital, University Health Network, MCL 2-405, 399 Bathurst St, Toronto, M5T 2S8, ON, Canada.
Mahesh NagappaDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Western University, London, Ontario, Canada.
Marina EnglesakisLibrary and Information Services, University Health Network, Toronto, Canada.
David WangCentre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia.
Philip PengDepartment of Anesthesiology and Pain Management, Toronto Western Hospital, University Health Network, MCL 2-405, 399 Bathurst St, Toronto, M5T 2S8, ON, Canada.
Frances ChungDepartment of Anesthesiology and Pain Management, Toronto Western Hospital, University Health Network, MCL 2-405, 399 Bathurst St, Toronto, M5T 2S8, ON, Canada. frances.chung@uhn.ca.ORCID 0000-0001-9576-3606
University Health Network · CAThe University of Sydney · AUWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeObstructive sleep apnea (OSA) is prevalent in patients with chronic non-cancer pain. OSA may lead to low sleep quality and an increase in pain sensitivity. Patients reporting greater sleep impairment tend to experience higher pain intensity and vice versa. Positive airway pressure (PAP) is the current gold standard treatment for OSA. This review aims to evaluate the efficacy of PAP therapy in patients with comorbid chronic pain and OSA in influencing pain outcomes like pain intensity, tolerance, threshold, and sensitivity.

methodsWe performed a systematic literature search for studies published after 1990, utilizing the following databases: Medline, Medline In-Process/ePubs, Embase, Cochrane CENTRAL, and the Cochrane Database of Systematic Reviews. Search terms included "chronic pain," "sleep disorders," and "positive airway pressure."

resultsOf 1982 initial studies, ten studies met the study inclusion criteria. Seven of these studies examined the effect of PAP therapy on chronic pain, of which five demonstrated improved pain outcomes, specifically, headache pain. The effect of PAP therapy on chronic non-headache pain was found to be inconclusive. When examining the three studies that did not involve chronic pain patients, PAP therapy effectively increased pain threshold and tolerance in two studies (p = 0.03 and p = 0.01).

conclusionAn association exists between PAP therapy and decreased chronic headache outcomes in patients with OSA. Additionally, research shows that PAP therapy may increase pain tolerance and threshold. Future high-quality evidence is required to further investigate the association between PAP and non-headache chronic pain.

Indexed as

Severity of Illness IndexAnalgesics, OpioidChronic PainContinuous Positive Airway PressureHumansPhysical Therapy ModalitiesQuality of LifeSleep Apnea, ObstructiveSleep QualityAnalgesics, OpioidChronic painHeadacheObstructive sleep apneaPositive airway pressureSleep-disordered breathing

Identifiers

PMID34021465
OpenAlexW3163454289

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.