Veteran using CPAP mask for sleep apnea and pain relief

CPAP and Chronic Pain: Is There a Link?

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"Exploring the effectiveness of CPAP therapy for veterans with obstructive sleep apnea and chronic pain management, and why adherence matters."

Chronic pain is a widespread and serious problem, especially among veterans and service members. The combination of physical injuries, traumatic brain injuries, and mental health challenges has led to increased reliance on opioid medications to manage pain. However, this approach can have significant drawbacks, including the development of sleep-disordered breathing.

Obstructive sleep apnea (OSA) is a common sleep disorder where breathing repeatedly stops and starts during the night. Continuous positive airway pressure (CPAP) therapy is often prescribed to keep airways open, but its effectiveness in patients with chronic pain who also rely on opioids has been unclear.

A study published in the Journal of Clinical Sleep Medicine investigates how CPAP therapy affects pain intensity and opioid use in veterans with OSA who are already on chronic opioid treatment. Understanding this relationship is essential for improving pain management strategies and overall quality of life for this population.

Does CPAP Therapy Reduce Pain and Opioid Use?

Veteran using CPAP mask for sleep apnea and pain relief

The study, led by Philippe Jaoude and colleagues, retrospectively examined data from veterans treated at a VA sleep center. The researchers compared 113 patients with OSA who were using opioid medications for non-malignant pain to a control group of 113 veterans with OSA who were not using opioids. Pain intensity was measured using the Numerical Categorical Scale before CPAP treatment and after 12 months. Opioid intake was assessed using the morphine equivalent daily dose (MEDD), and CPAP adherence was tracked using the device's built-in meter.

The researchers aimed to determine whether CPAP adherence could alleviate pain and reduce opioid consumption in veterans with OSA. However, the results indicated that CPAP treatment did not significantly reduce pain intensity or opioid use in veterans with chronic pain and coexisting OSA.

CPAP adherence was significantly lower in the opioid-treated group compared to the control group (37% vs. 55%, p = 0.01).
Greater pain intensity was the only independent variable associated with CPAP non-adherence at the 12-month follow-up (p = 0.03).
No significant difference was observed in pain intensity or opioid consumption in CPAP-adherent patients compared to baseline.

These findings suggest that simply treating OSA with CPAP may not be enough to address the complex interplay between chronic pain, opioid use, and sleep quality. Other factors, such as underlying mental health conditions and individual pain management strategies, may play a more significant role.

The Importance of CPAP Adherence and Comprehensive Pain Management

The study highlights the importance of CPAP adherence, as veterans on opioids had significantly lower adherence rates than those not on opioids. Pain intensity was identified as the primary factor influencing CPAP adherence, suggesting that managing pain effectively is crucial for improving treatment outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5664/jcsm.6046, Alternate LINK

Title: Pain Intensity And Opioid Utilization In Response To Cpap Therapy In Veterans With Obstructive Sleep Apnea On Chronic Opioid Treatment

Subject: Neurology (clinical)

Journal: Journal of Clinical Sleep Medicine

Publisher: American Academy of Sleep Medicine (AASM)

Authors: Philippe Jaoude, Ashima Lal, Leah Vermont, Jahan Porhomayon, Ali A. El-Solh

Published: 2016-08-15

Everything You Need To Know

What is the basic problem described and who is primarily affected?

Chronic pain, especially in veterans, is a significant issue often managed with opioid medications. Opioids, while helpful for pain, can lead to sleep-disordered breathing. The study's context underlines the complexity of this interplay and the need for comprehensive strategies.

What is Obstructive Sleep Apnea (OSA) and what is CPAP therapy?

Obstructive Sleep Apnea (OSA) is a sleep disorder where breathing repeatedly stops and starts during sleep. CPAP (Continuous Positive Airway Pressure) therapy is a treatment that uses a machine to provide constant air pressure to keep the airways open. This study investigates CPAP's effectiveness in veterans dealing with both OSA and chronic pain, which is a particularly vulnerable population.

What was the main objective of the research that was performed?

The study explored how CPAP therapy affects pain intensity and opioid use in veterans with OSA who were already on chronic opioid treatment. It examined data from veterans at a VA sleep center, comparing those on opioids to a control group. It measured pain intensity using the Numerical Categorical Scale before and after CPAP, tracked opioid intake, and monitored CPAP adherence.

What were the key findings of the study regarding CPAP therapy?

The study found that CPAP therapy did not significantly reduce pain intensity or opioid use in veterans with both chronic pain and OSA. However, CPAP adherence was notably lower in the opioid-treated group. This highlights that CPAP alone may not be sufficient, and other factors like pain management strategies and mental health may have a more significant impact.

Why is CPAP adherence important, and what factors influence it?

CPAP adherence is crucial because it directly impacts treatment outcomes. The study revealed that veterans on opioids had lower CPAP adherence rates, and pain intensity was the main factor linked to non-adherence. Effective pain management is therefore essential for improving CPAP adherence and, by extension, improving overall health and quality of life for veterans with OSA.