ArticlePain2026
Chronic pain is associated with sleep apnea severity but attenuated by intermittent hypoxemia in people using opioids.
Article in Pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
abstractPatients using long-term opioids for pain often have uncontrolled symptoms which might drive ongoing opioid use and contribute to the opioid public health crisis. Opioids also cause sleep disordered breathing (SDB), which might impact pain via arousals and hypoxemia, with potential for a vicious cycle. Adults with noncancer pain using opioids daily for >3 months were recruited. Subjects underwent pain and sleep questionnaires, pain tolerance via 10°C cold pressor testing, and polysomnography. Hypoxic burden was determined from polysomnographic signal analysis. Participants (n = 143) had a median (interquartile range) age of 60 (51, 67) years, body mass index 29 (25, 35) kg/m 2 . 80 (56%) subjects were female. The median daily morphine equivalent dose was 20 (10, 45). 78% had an apnea-hypopnea index (AHI) >5/hour and 41% with AHI >15/hour. PROMIS pain interference scores differed across SDB severity, with increased symptoms in mild and moderate but not severe SDB. With increasing AHI, there was worsened pain (β = 2.2 [95% confidence interval [CI]: 0.08, 4.4]; β std = 1.3; P = 0.043), but this relationship was attenuated at higher levels of hypoxic burden (per interaction; β = -0.42 [95% CI: -0.78, -0.06]; β std = -0.85; P = 0.023). During cold pressor testing, there was a reduced time to hand withdrawal with increasing AHI (hazard ratio [HR] 2.60 [95% CI: 1.48, 4.57]; P = 0.001), but this was also attenuated at higher hypoxic burden (HR: 0.86 [95% CI: 0.78, 0.94]; P = 0.002). Overall, SDB is linked with worsened pain in those using opioids for chronic pain, but hypoxemia attenuates the effect. Individuals with the same AHI may have different symptoms depending on hypoxic burden. Interventional studies will help elucidate mechanisms and the role for SDB treatment in pain management.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.