Obstructive sleep apnea co-morbidity in patients with fibromyalgia: A single-center retrospective analysis and literature review

Edwin S. Meresh, Hewa Artin, Cara Joyce, Steven Birch, David Daniels, Jack H. Owens, Alvaro J.L. La Rosa, Murali S. Rao, Angelos Halaris

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: Fibromyalgia (FM) is a chronic medical condition characterized by widespread pain, sleep disturbance, and cognitive dysfunction. Sleep disorders are thought to play a prominent role in the etiology and symptomatic management of FM, specifically obstructive sleep apnea (OSA). In order to provide collaborative care, we need a better understanding of any overlapping presentation of FM and OSA. We conducted a site-wide review of patients from 2012-2016 to identify FM patients diagnosed with OSA. Methods: Charts were reviewed in patients aged 18 and above from 2012-2016 using ICD codes from a clinical data repository. Intersection of patients with a diagnosis of FM and OSA in clinics of psychiatry, sleep, rheumatology, and other outpatient clinics was compared. Polysomnography order patterns for FM patients were investigated. Results: Co-morbidity was highest in the sleep clinic (85.8%) compared to psychiatry (42.0%), rheumatology (18.7%), and other outpatient clinics (3.6%) (p<0.001). In the rheumatology and other outpatient clinics, 93.5% and 96% of patients respectively, had no polysomnography ordered. Pairwise comparison of co-morbidity in clinics: sleep vs psychiatry, sleep vs rheumatology, sleep vs other clinics, psychiatry vs rheumatology, psychiatry vs other clinics, and rheumatology vs other clinics were statistically significant after applying a Sidak adjustment to the p-values (all p<0.001). Conclusion: Our analysis suggests that there could be a correlation between FM and OSA, and referral to sleep studies is recommended in the management of patients with FM. The varying prevalence of FM patients with co-morbid OSA in sleep clinics when compared to other outpatient clinics suggests a discrepancy in the identification of FM patients with OSA. When properly screened, OSA co-morbidity has the potential to be higher in other outpatient clinics.

Original languageEnglish
Pages (from-to)103-109
Number of pages7
JournalOpen Access Rheumatology: Research and Reviews
Volume11
DOIs
StatePublished - 2019

Keywords

  • Co-morbidity
  • Fibromyalgia
  • Obstructive sleep apnea
  • Psychiatry
  • Rheumatology
  • Sleep

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