Session Information
Date: Monday, October 22, 2018
Title: 4M082 ACR Abstract: Fibromyalgia & Other Clinical Pain Syndromes (1834–1839)
Session Type: ACR Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
Background/Purpose:
Up to 50% of sleep apnea (SA) patients have fibromyalgia (FM). Little is known about the prevalence and associations of SA and FM, and the impact of continuous positive airway pressure (CPAP) use in patients with FM.
Methods:
Consecutive patients diagnosed with FM by clinical and/or ACR 2010 criteria, were enrolled and classified according to reported history of SA and CPAP use. Sleep characteristics and FM measures of severity, depression and function were compared between groups.
Results:
Characteristics of 667 FM patients were: age 45.9±37.6, 89.5% female, 79.9% white, BMI 30±8.7, Fibromyalgia impact questionnaire score 63.5±20.1, Epworth Sleepiness Scale 9.5±5.9, hours of sleep 6.1±2.0, 85.9% reported unrefreshing sleep, 65% trouble falling asleep, 73.7% trouble staying asleep. Prior diagnosis of SA was reported by 154 (21%) FM patients, of which 50 patients (32.4%) used CPAP, for 6.4±1.4 days/week. Comparisons between FM with SA and without, and between CPAP users and non users are presented in Table 1 and Table 2.
|
Table 1. Comparison between FM patients with and without a prior history of sleep apnea. |
|||
|
No prior diagnosis of sleep apnea N 513 |
Prior diagnosis of sleep apnea N 154 |
p |
|
|
Age |
45.4 ±11.1 |
48.12±11.8 |
0.746 |
|
BMI |
29±7.7 |
33.6±10.5 |
0.000 |
|
Hours of sleep/night |
6.0±1.9 |
6.3±2.2 |
0.559 |
|
ESS |
9.1±5.9 |
10.5±5.7 |
0.014 |
|
Patient health questionnaire -9 (PHQ-9) |
12.2±6.1 |
11±6.94 |
0.006 |
|
Fibromyalgia impact questionnaire (FIQ) |
63.6±18.5 |
64.3±23.7 |
0.587 |
|
Health assessment questionnaire -disability index (HAQ-DI) |
1.0±1.46 |
1.2±1.1 |
0.411 |
|
Widespread pain index (WPI) |
12.1±9.0 |
12.4±4.4 |
0.905 |
|
Symptom severity scale (SS) |
8.8±2.3 |
9.3±2.4 |
0.021 |
|
Fibromyalgianess scale (PSD) |
21.1±10.0 |
22.1±5.4 |
0.559 |
|
Unrefreshing sleep |
89.5% N 459 |
86.4% N 133 |
0.000 |
|
Trouble falling asleep |
67.6% N 347 |
65.6% N 101 |
0.000 |
|
Trouble staying asleep |
78% N 400 |
75.3% N 116 |
0.000 |
|
Table 2. Comparison between FM patient with sleep apnea who used CPAP regularly with those who did not use CPAP |
|||
|
Not using CPAP N 104 |
Using CPAP N 50 |
p |
|
|
Age |
47.6±13.0 |
49.5±9.4 |
0.7 |
|
BMI |
32.0±10.2 |
36.3±11.0 |
0.000 |
|
Hours of sleep/night |
6.2±2.4 |
6.4±2.0 |
0.491 |
|
ESS |
9.6±7.0 |
12.0±5.9 |
0.006 |
|
PHQ9 |
14.4±7.0 |
13.1±6.8 |
0.013 |
|
FIQ |
63.5±23.9 |
65.9±24.0 |
0.405 |
|
HAQDI |
1.2±1.3 |
1.2±1.1 |
0.487 |
|
WPI |
12.0±4.5 |
12.8±4.3 |
0.812 |
|
SS |
9.1±2.5 |
9.4±2.0 |
0.408 |
|
PSD |
21.5±5.5 |
22.5±5.3 |
0.684 |
|
Unrefreshing sleep |
88.7% N 86 |
84.7% N 42 |
0.259 |
|
Trouble falling asleep |
71.5% N 69 |
56% N 29 |
0.215 |
|
Trouble staying asleep |
82.5% N 80 |
60% N 30 |
0.033 |
Conclusion:
Quality of sleep was poor in FM; SA was reported by 1/5 FM patients, who had higher BMI, SS, and were more depressed; 1/3rd of FM SA patients used CPAP; compared to those who did not, CPAP users where more obese, had higher daytime sleepiness, were less depressed and had less trouble staying asleep. Longitudinal studies are needed to determine the true prevalence of sleep apnea in FM, confirm and understand the directionality of these observations.
To cite this abstract in AMA style:
Gota CE, Jhala N, Kaouk S, Kinanah Y, Wilke W. Sleep Apnea and Fibromyalgia: Data from the Cleveland Clinic Fibromyalgia Registry [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/sleep-apnea-and-fibromyalgia-data-from-the-cleveland-clinic-fibromyalgia-registry/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/sleep-apnea-and-fibromyalgia-data-from-the-cleveland-clinic-fibromyalgia-registry/