Neurotoxic Exposure Among Veterans and Obstructive Sleep Apnea: The Moderation of Pain with Obesity

• Published in: Obesity (Silver Spring, Md.) Md.), 2023-11, Vol.31, p.213-213
• Main Authors: Chacko, Thomas, Faith, Myles, Samuel, Immanuel, Allison, Kelly, Broderick, Gordon
• Format: Article
• Language: English
• Subjects: Chronic pain; Obesity; Sleep apnea; Weight control
• ISSN: 1930-7381; 1930-739X

Background: Obesity is a major risk factor for obstructive sleep apnea (OSA). Further, chronic pain renders obesity management harder. Yet, little is known about the relationship between obesity and OSA in the context of pain among older Veterans. The current study aimed to test the hypothesis that chronic pain would moderate the association of obesity with OSA in the Agent Orange (AO)-exposed group, not in the non-exposed group. Veterans were stratified per their exposure to AO, an organophosphate, known to trigger adverse chronic health outcomes. Methods: Vietnam Veterans completed a battery of self-report questionnaires as part of a larger cross-sectional study (N = 350; AgeMean = 74.4 years; SD = 3.6 years). Moderated multiple regression (Process macro version 4.1, model 1) was used to test the models across two stratified groups. Results: Veterans were mostly White (95%), male (98%), from Army (55%). Of the total sample, 50.3% reported АО-exposure during deployment, whereas 49.7% reported no АО-exposure. Per t-tests, pain (p < 0.001) and OSA (p = 0 01) were statistically different across exposure groups. While BMI mean differences were not significant, the АО-exposed reported slightly higher BMI (BMIMean = 30.24 (SD = 5.9) versus non-exposed group (BMIMean = 29.55 (SD = 5.5). Multiple regression yielded statistically different findings across exposure groups. For the AO-exposed group, there was significant main effect of BMI (β = 0.17, p < 0.001), and significant interaction of pain, such that the relationship of BMI and OSA differed depending on pain level (p = 0.02; LLC = -0.03, ULCI = -0.002). The model explained 38% of the variance in OSA (R2 = 0.38). Simple slope analysis provided visual representation of the interactions. For the non-exposed group, there was no statistically significant interaction of pain (p = 0.42; LLCI = -0.025, ULCI = 0.010). Conclusions: Findings suggest that pain management interventions might be especially relevant for veterans with AO-exposure in the management of comorbid obesity and OSA.