Impact of Central Sensitization on Sleep and Pain Perception in Patients with Fibromyalgia and Obstructive Sleep Apnea
DOI:
https://doi.org/10.58600/eurjther2705Keywords:
fibromyalgia, obstructive sleep apnea, chronic pain, pain behaviourAbstract
Objective: This study aimed to examine the relationship between symptom profiles associated with central pain processing and sleep disturbances in female patients diagnosed with obstructive sleep apnea (OSA), with and without comorbid fibromyalgia (FM).
Methods: Seventy women aged 18 to 60 with obstructive sleep apnea (OSA) diagnosed according to American Academy of Sleep Medicine (AASM) criteria were included. Participants were categorized into two groups according to the 2016 categorization criteria established by the American College of Rheumatology (ACR): individuals diagnosed alone with OSA and those diagnosed with both OSA and FM. The patients’ sleep was assessed by polysomnography (PSG) and the Pittsburgh Sleep Quality Index (PSQI). Symptom burden related to central pain mechanisms was assessed using the Central Sensitization Inventory (CSI). Pain intensity, anxiety-depression levels, and quality of life were evaluated utilizing the Visual Analog Scale (VAS), the Hospital Anxiety and Depression Scale (HADS), the Fibromyalgia Impact Questionnaire (FIQ), and the 36-Item Short Form Health Survey (SF-36).
Results: The groups were similar in age and body mass index (BMI). FM + OSA patients had significantly higher CSI, PSQI, HADS, and VAS scores and lower SF-36 scores (p < 0.05). They also showed lower SaO₂, reduced REM sleep, and higher ODI and arousal index (p < 0.001). CSI scores positively correlated with disrupted sleep measures.
Conclusion: Higher CSI scores in FM + OSA patients were associated with poor sleep quality, increased pain intensity, and reduced quality of life. These findings suggest that pain hypervigilance and related symptoms may contribute to sleep disturbances in this group.
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