Sleep symptoms impair fibromyalgia patients’ QoL

Oct 22 2012

By Lynda Williams, Senior medwireNews Reporter

A study of fibromyalgia patients highlights the impact of sleep symptoms on health-related quality of life (HRQoL) in this population.

Just 11.2% of 2196 fibromyalgia patients identified using the 2009 National Health and Wellness Survey reported no difficulty with falling asleep, staying asleep or early wakening, while 25.7% reported one and 63.1% two or three symptoms.

This pattern of symptoms differed significantly from that of 2194 age-, gender-, ethnicity- and comorbidity-matched controls, 40.7% of whom had no sleep symptoms, 29.0% had one symptom, and 30.3% had two or more.

Of concern, fibromyalgia patients with two or three sleep symptoms were significantly more likely than those with no or one symptoms to report both severe pain (43.26 vs 19.08 and 30.77%), and daily pain (70.88 vs 49.21 and 59.67%).

Difficulty sleeping also significantly correlated with fibromyalgia patient scores on the physical and mental domains of the Medical Outcomes Study Short Form-12 questionnaire version 2 (SF-12v2), with one or two/three symptoms associated with clinically relevant deficits in HRQoL.

Fibromyalgia patients had significantly poorer SF-12v2 scores than controls. Furthermore, the relationship between the number of sleep difficulties and the impact on HRQoL differed between patients and controls, "suggesting a uniqueness of the burden of sleep difficulties within the [fibromyalgia] population," say Marco DiBonaventura (Kantar Health, New York, USA) and co-authors.

They explain: "In most cases, the decrement between no sleep difficulty symptoms and one sleep difficulty symptom was larger among those patients with [fibromyalgia]; conversely, the quality of life decrement between one and two or more sleep difficulty symptoms was larger among matched controls."

Writing in BMC Musculoskeletal Disorders, the team concludes that "the improved management of these sleep difficulty symptoms among patients with FM may lead to clinically-relevant improvements in HRQoL."

While improving pain relief may reduce sleep symptoms, DiBonaventura et al note that HRQoL symptoms were influenced by sleep symptoms even after adjusting for pain management, indicating that "the management of sleep difficulties likely extends beyond the mere alleviation of pain."

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