OBJECTIVES:Fibromyalgia syndrome (FMS) is characterized by complaints of chronic musculoskeletal pain, fatigue, and difficulty in falling asleep. Obstructive sleep apnea syndrome (OSAS) is associated with symptoms, such as morning fatigueness and unrefreshing sleep. We aimed to investigate the presence of OSAS and objectively demonstrate changes in sleep pattern in patients with FMS.
MATERIAL AND METHODS:Polysomnographic investigations were performed on 24 patients with FMS. Patients were divided into two groups: patients with and without OSAS (Group 1 and Group 2, respectively). A total of 40 patients without FMS who presented to the sleep disorders polyclinic with an initial diagnosis of OSAS were included in Group 3. Based on their apnea hypopnea index (AHI), OSAS in the patients were categorized as mild (AHI,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), moderate (30), or severe (>30).
RESULTS:OSAS was detected in 50% of patients with FMS. The most prominent clinical findings were morning fatigue and sleep disorder, which were similar in three groups. In polysomnography (PSG) evaluation, patients with FMS had mild (33%), moderate (25%), and severe (42%) OSAS. In correlation analyses, negative correlations were observed between fibromyalgia impact questionnaire (FIQ) and mean oxygen saturation, visual analogue scale (VAS), and minimum oxygen saturation, whereas a positive correlation was found between FIQ and desaturation times in patients with FMS.
CONCLUSION:Detection of OSAS in 50% of the patients with FMS, and similar rates of complaints of sleep disorder and morning fatigue of OSAS and FMS cases are important results. Detection of correlation between the severity of hypoxemia and FIQ and VAS scores are significant because it signifies the contribution of increased tissue hypoxemia to the deterioration of clinical status. Diagnosis and treatment of OSAS associated with FMS are important because of their favorable contributions to the improvement of the clinical picture of FMS.
KEYWORDS:Obstructive sleep apnea syndrome, fibromyalgia syndrome, polysomnography, sleep disorders, apnea hypopnea index, hypoxemia
INTRODUCTIONFibromyalgia syndrome (FMS) is a chronic health problem that presents with pain all over the body, with other symptoms, such as tenderness of the affected joints, muscles fatigue, sleep problems (waking up unrefreshed and excessive daytime sleepiness), and cognitive impairment [1]. Since its etiology is not fully known, its treatment is symptomatic. Patients with FMS are usually treated with various combinations of physiotherapy, psychotherapy, psychotrophic drugs, and analgesics. Treatment effectiveness in FMS is limited, and these patients frequently lead their lives with symptoms of chronic insomnia, sleep problems, fatigue, and pain [2].Obstructive sleep apnea syndrome (OSAS) is a pathology with systemic effects that are characterized by associated symptoms of recurrent episodes of upper respiratory tract obstruction, hypoxemia, arousals during sleep, morning fatigue because of impaired sleep ...