Roundup: New Cases of Chronic Pain Outpacing Other Common Conditions; Poor Sleep Linked to Higher Risk of Cognitive Decline; and More News

NIH Study: News Cases of Chronic Pain Outpacing New Cases of Diabetes, Hypertension

New cases of chronic pain among U.S. adults are outpacing new cases of many other common conditions, including diabetes, depression, and high blood pressure, according to a new study from the National Institutes of Health, Seattle Children’s Research Institute, and the University of Washington at Seattle. Findings are published in JAMA Network Open.

Overall, researchers found that the rate of chronic pain and high-impact chronic pain (HICP) among adults is about 21 percent and 8 percent, respectively. Chronic pain refers to pain that is experienced on most days or every day in the past three months; and HICP is pain that limits life or work activities on most days or every day during the past three months, states the NIH in a news release.

“Understanding incidence, beyond overall prevalence, is critical to understanding how chronic pain manifests and evolves over time," said Richard Nahin, Ph.D., lead author and lead epidemiologist at the National Center for Complementary and Integrative Health (NCCIH) at the NIH. "These data on pain progression stress the need for increased use of multimodal, multidisciplinary interventions able to change the course of pain and improve outcomes for people.”

The NIH study reviewed data on pain among survey participants and compared their responses in 2020 to their baseline status in 2019. The study's key findings:

• The incidence of new chronic pain cases was high, at 52.4 cases per 1,000 persons per year. This is compared to other common chronic conditions, such as diabetes (7.1 cases/1,000 per year), depression (15.9 cases/ 1,000 per year), and hypertension (45.3 cases/1,000 per year).
• Among those who had not reported chronic pain in 2019, about 1 in 6 (14.9 percent) said they had chronic pain in 2020.
• Chronic pain is highly persistent, with almost two-thirds (61.4 percent) of those who reported chronic pain in 2019 still reporting chronic pain a year later. Chronic pain developed into HICP at a rate of 190 cases/1,000 per year, and 361 cases/1,000 per year of people who had initially reported HICP were still suffering a year later.
• About 1 in 10 (10.4 percent) of people with chronic pain in 2019 recovered and were pain free in 2020.

Severe Sleep Apnea, Lack of ‘Deep Sleep’ Linked to Higher Risk of Cognitive Decline, Stroke

People who have sleep apnea -- a disorder that causes breathing to slow or stop multiple times during sleep -- and those who spend less time in deep sleep may be at a higher risk of stroke, Alzheimer’s disease and cognitive decline, according to new research published in Neurology, the medical journal of the American Academy of Neurology.

The researchers from the Mayo Clinic emphasize that their findings "do not prove that these sleep disturbances cause the changes in the brain, or vice versa." It only shows an association, they point out.

The study focused on sleep factors and biomarkers of the health of the brain’s white matter. One of the biomarkers, known as "white matter hyperintensities," are tiny lesions visible on brain scans. White matter hyperintensities become more common with age or with uncontrolled high blood pressure. The other biomarker measures the integrity of the axons, which form the nerve fibers that connect the brain’s nerve cells.

“These biomarkers are sensitive signs of early cerebrovascular disease,” said study author Diego Z. Carvalho, M.D., of the Mayo Clinic in Rochester, Minnesota, and a member of the American Academy of Neurology, in a news release. “Finding that severe sleep apnea and a reduction in slow-wave sleep are associated with these biomarkers is important since there is no treatment for these changes in the brain, so we need to find ways to prevent them from happening or getting worse.”

Healthy sleep is not just vital for brain health. It's also a component of heart health. Proper sleep duration of 7 to 9 hours a night for adults, and more for children, was recently added as an essential part of healthy living by the American Heart Association (AHA). Sleep health is now part of the AHA’s “Life’s Essential 8” factors for achieving optimum cardiovascular health.

The new study from Mayo on sleep and brain health involved 140 people diagnosed with sleep apnea whose average age was 73. The researchers analyzed data from MRIs of the study participants' brains and from overnight sleep studies.

Researchers examined how long they spent in “slow-wave sleep” -- also called “non-REM stage 3” or deep sleep. The amount of deep sleep is considered one of the best markers of sleep quality. The study team noted that for every 10-point decrease in the percentage of slow-wave sleep, there was an increase in the amount of white matter hyperintensities, which is “similar to the effect of being 2.3 years older.”

They also found that those with severe sleep apnea had a higher volume of white matter hyperintensities than those with mild or moderate sleep apnea. The researchers accounted for age, sex and conditions that could affect risk of brain changes, such as high blood pressure and high cholesterol.

“More research is needed to determine whether sleep issues affect these brain biomarkers or vice versa,” stated Dr. Carvalho in a statement. “We also need to look at whether strategies to improve sleep quality or treatment of sleep apnea can affect the trajectory of these biomarkers.”

Clinical Trial on Toddlers Shows Promise of Skin Patch to Reduce Peanut Allergies

A skin patch could prevent severe allergic reactions in toddlers with peanut allergies, according to research from a clinical trial. In the study, published in The New England Journal of Medicine, researchers from the French biopharmaceutical company DBV Technologies and other institutions tested the Viaskin Peanut patch on children with peanut allergies aged one- to three-years-old.

The research involved 362 toddlers from eight different nations -- 244 were given the Viaskin patch, which contains 250 micrograms of peanut protein, or about 1/1000th of a peanut, and 118 got a placebo patch. Before undergoing testing for peanut allergies, they wore the patches every day for a year between their shoulder blades.

A new patch is applied each daily allowing the skin to absorb the protein. Immune cells then carry the protein to other parts of the body, where they help suppress the allergic response, states DBV Technologies.

In the skin patch study, two-thirds of the children who used the Viaskin patch and one-third of the placebo group had achieved some degree of desensitization to peanuts after 12 months. Children with a less sensitive allergy could safely tolerate peanut protein equivalent to consuming three or four peanuts. Children who were more sensitive could tolerate the equivalent of consuming one peanut.

About 1 in 50 children in the U.S. have a peanut allergy. There are no approved treatments for kids under the age of four who suffer from peanut allergies. The Palforzia powder, which may be used with foods such as applesauce, yogurt, or pudding, has been approved by the U.S. Food and Drug Administration (FDA) for use by children between the ages of 4 and 17. The powder also could reduce the likelihood of severe allergic responses in children by gradually raising their tolerance to peanuts.

“The efficacy and safety of epicutaneous (on the surface of the skin) immunotherapy with a peanut patch in toddlers with peanut allergy are unknown,” researcher stated. “In this trial involving children 1 to 3 years of age with peanut allergy, epicutaneous immunotherapy for 12 months was superior to placebo in desensitizing children to peanuts and increasing the peanut dose that triggered allergic symptoms.”