Sleep and Neuropathic Disorders: Insights into Risk and Comorbidity Patterns Using the All of Us Research Program
John Abdallah1, Amaan Virdi1, Will Potratz1, Arth Thaker1, Frank Scali1
1School of Medicine, California University of Science & Medicine
Objective:
Determine whether sleep disorders correlate with a higher risk of developing neuropathic disorders, neuropathy, and greater neuropathic symptom severity.
Background:
Neuropathic pain, commonly due to peripheral neuropathy and lumbar radiculopathy (LR), is a leading cause of disability, affecting approximately 7-10% of the adult population. While LR is often due to degenerative spine disease, 25-46% of peripheral neuropathy cases remain idiopathic. Sleep disorders, including insomnia and obstructive sleep apnea (OSA), impact millions and are linked to worse neuropathic pain and inflammation, yet population-level studies on this risk remain limited.
Design/Methods:
We reviewed All of Us Registered Tier Dataset v8, including patients with neuropathy diagnosed at least 7 days after a sleep disorder diagnosis (“Cohort 1”) and neuropathy-only patients (“Cohort 2”). Exclusions included those deceased, history of stroke, hypothyroidism, HIV/AIDS, alcohol use disorder, chemotoxicity, or hematologic disorders. Analyses were conducted using RStudio.
Results:
A total of 27,444 participants were included in Cohort 1, and 73,415 in Cohort 2. LR following insomnia was the most common neuropathic disorder among patients with sleep disorders, occurring in 4.9% of cases. Insomnia was associated with a 15.6% higher risk of polyneuropathy (RR 1.16, 95% CI 1.04–1.29), while OSA conferred a 2.6% higher risk of LR (RR 1.03, 95% CI 0.95–1.11). Cohort 1 participants were older (63.9 vs. 62.02 years) and had higher BMI (33.12 vs. 31.15). Pain scores were elevated in Cohort 1 (4.36 vs. 3.92, p < 0.001), and mild-to-moderate fatigue was reported in both groups (p < 0.001).
Conclusions:
Insomnia and OSA were associated with a higher risk of specific neuropathic disorders, particularly polyneuropathy and lumbar radiculopathy, respectively. Older age, higher BMI, and elevated pain scores may further characterize populations at greater risk, highlighting the need for targeted management strategies in patients with sleep disorders.
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