Additive Effects of Insomnia and Depression on Osteoarthritis Save

A study of osteoarthritis patients, finds that pain is the primary driver for health care utilization, and that the presence of insomnia or depression augments health care use.

 A total of 2976 OA patients were followed for 3 years and assessed for pain (Graded Chronic Pain Scale), insomnia (Insomnia Severity Index), and depression (Patient Health Questionnaire‐8), and health care use (from electronic health records).

OA patients, half of whom had moderate‐to‐severe pain, and nearly 54% had subclinical or clinical insomnia and 45% had subclinical or current depression.

Pain had the greatest independent effects on increasing all types of health care use. This was followed by depression with  moderate effects on increased office visits, length of stay, outpatient and inpatient costs. Insomnia had mild effects on decreased length of stay. 

There was no synergistic effects of the 3 symptoms on use of health care services.

Pain plus insomnia and pain plus depression significantly increased all types of health care use.

These findings underscore the importance of managing sleep and depression in patients with osteoarthritis.