Hospices Civils de Lyon, Pôle Gériatrie, Hôpital Gériatrique Antoine Charial, Francheville, France.
J Am Med Dir Assoc. 2010 Nov;11(9):612-6. doi: 10.1016/j.jamda.2010.04.003.
Patients with painful conditions often suffer from sleep disturbances. However, changes in sleep pattern per se could also influence pain tolerance. Untreated obstructive sleep apnea (OSA) causes major disturbances in sleep pattern. The aim of this study was to assess whether continuous positive airway pressure (CPAP) treatment in elderly patients with OSA would result in improved pain tolerance.
Randomized, double-blind crossover study.
Geriatric sleep center based in Antoine Charial University Hospital (Lyon, France).
A total of 13 consecutive OSA patients aged 70 and older randomly assigned CPAP treatment (lowCPAP versus highCPAP). Eleven patients completed the study.
Overnight sleep recording, electrical pain tolerance assessment, and visual analog scale for sleep quality were performed.
Both low- and highCPAP treatment significantly improved respiratory parameters. However, compared with baseline, the electrical pain tolerance score was significantly enhanced (analgesic effect) only under highCPAP treatment (21.2 ± 10.9 versus 28.4 ± 16.0; P = .03).
The treatment of OSA with CPAP would have an analgesic effect. This would represent a unique outcome attributed to CPAP treatment. Given the high prevalence of both OSA and chronic pain conditions in the elderly; our findings could hold many implications for very large segments of the elderly population.
患有疼痛病症的患者常伴有睡眠障碍。然而，睡眠模式的改变本身也可能影响疼痛耐受力。未经治疗的阻塞性睡眠呼吸暂停（OSA）会导致严重的睡眠模式紊乱。本研究旨在评估持续气道正压通气（CPAP）治疗老年 OSA 患者是否会提高疼痛耐受力。
随机、双盲交叉研究。
位于法国里昂 Antoine Charial 大学医院的老年睡眠中心。
共纳入 13 名年龄在 70 岁及以上的连续 OSA 患者，随机分配 CPAP 治疗（低 CPAP 与高 CPAP）。11 名患者完成了研究。
整夜睡眠记录、电痛耐受力评估和睡眠质量视觉模拟评分。
低 CPAP 和高 CPAP 治疗均显著改善呼吸参数。然而，与基线相比，仅在高 CPAP 治疗下，电痛耐受力评分显著提高（镇痛效果）（21.2 ± 10.9 与 28.4 ± 16.0；P =.03）。
CPAP 治疗 OSA 具有镇痛作用。这将代表 CPAP 治疗的独特效果。鉴于老年人中 OSA 和慢性疼痛病症的高患病率；我们的研究结果可能对老年人群中的很大一部分人具有重要意义。
