Sleep quality in fibromyalgia patients and its association with disease severity, pain, depression and fatigue: Fibromiyalji hastalarında uyku kalitesi ve hastalık şiddeti, ağrı, depresyon ve yorgunlukla ilişkisi

Yeşim Garip; Dilek Öztaş; Tuba Güler; Özgül Bozkurt Tuncer

doi:10.5152/EurJTher.2016.001

Authors

Yeşim Garip Pinar Physical Therapy and Rehabilitation Center, Ankara
Dilek Öztaş Department of Public Health, Faculty of Medicine, Yildirim Beyazit University, Ankara
Tuba Güler Clinic of Physical Medicine and Rehabilitation, Derince Training and Research Hospital, Kocaeli
Özgül Bozkurt Tuncer Pinar Physical Therapy and Rehabilitation Center, Ankara

DOI:

https://doi.org/10.5152/EurJTher.2016.001

Keywords:

Fatigue, fibromyalgia, sleep disorders, pain

Abstract

Introduction: In this cross-sectional study, we aimed to investigate sleep quality in the patients with fibromyalgia (FM), to determine the association of sleep disorders with disease severity, tender point count, severity of pain, fatigue and depression and as well as to assess the impact of poor sleep quality on quality of life.

Materials and Methods: A total of 100 FM patients and 70 age and sex-matched healthy controls were included in the study. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Fibromyalgia Impact Questionnaire (FIQ) was used for determining disease severity. Quality of life was evaluated by using Nottingham Health Profile (NHP) and severity of pain by Visual Analog Scale (VAS).

Results: FM patients scored significantly higher in all subgroups of PSQI when compared with the controls (p< 0.01). PSQI was correlated with FIQ, tender point count, VAS, and pain and sleep subgroups of NHP (p< 0.05). Emotional reaction subgroup of NHP was correlated with all PSQI subgroups except sleep latency and use of sleep medicine (p< 0.01). No statistically significant correlation was foundbetween PSQI and social isolation, energy and physical mobility subgroups of NHP (p> 0.05). FSS was correlated with sleep disturbance subgroup of PSQI (p< 0.05). BDS scores were correlated with sleep disturbance and global scores of PSQI (p< 0.05).

Conclusion: FM patients have poor sleep quality when compared to healthy controls. Sleep quality is associated with disease severity, pain, depression and fatigue and it has a negative impact on quality of life in FM patients.

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References

Yunus MB, Arslan S, Aldag JC. Relationship between body mass index and fibromyalgia features. Scand J Rheumatol 2002;31(1):27-31.

Clauw DJ. Fibromyalgia and related conditions. Mayo Clin Proc 2015;90(5):680-92.

Jay GW, Barkin RL. Fibromyalgia. Dis Mon 2015;61(3):66-111.

Clauw DJ. Fibromyalgia: an overview. Am J Med 2009;122(12):3-13.

Perrot S, Winkelmann A, Dukes E, Xu X, Schaefer C, Ryan K, et al. Characteristics of patients with fibromyalgia in France and Germany. Int J Clin Pract 2010;64(8):1100-8.

Tomasevic-Todorovic S, Pjevic M, Boskovic K. Fibromyalgiauptodate aspects of pathophysiology diagnosis and treatment. Med Pregl 2010;63(7-8):507-11.

Choy EH. The role of sleep in pain and fibromyalgia. Nat Rev Rheumatol 2015;11(9)513-20. doi: 10.1038/nrrheum.2015.56.

Pimentel MJ, Gui MS, Reimão R, Rizzatti-Barbosa CM. Sleep quality and facial pain in fibromyalgia syndrome. Cranio 2015;33(2):122-8.

Wagner JS, DiBonaventura MD, Chandran AB, Cappelleri JC. The association of sleep difficulties with health-related quality of life among patients with fibromyalgia. BMC Musculoskelet Disord 201;13:199.

Consoli G, Marazziti D, Ciapparelli A, Bazzichi L, Massimetti G, Giacomelli C, et al. Theimpact of mood, anxiety, and sleep disorders on fibromyalgia. Compr Psychiatry 2012;53(7):962-7.

Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33(2):160-72.

Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000;20(1):9-12.

Kucukdeveci AA, McKenna SP, Kutlay S,Gürsel Y, Whalley D, Arasil T. The development and psycometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res 2000; 23(1):31-8.

Price DD, McGrath P, Rafii A,Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17(1):45-56.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193-213.

Agargün MY, Kara H, Anlar O. Validity and reliability of the Pittsburgh Sleep Quality Index in Turkish sample. Turk Psikiyatri Derg 1996;7:107-15.

Miró E, Martínez MP, Sánchez AI, Prados G, Medina A. When is pain related to emotional distress and daily functioning in fibromyalgia syndrome? The mediating roles of self-efficacy and sleep quality. Br J Health Psychol 2011;16(4):799-814.

Ulus Y, Akyol Y, Tander B, Durmus D, Bilgici A, Kuru O. Sleep quality in fibromyalgia and rheumatoid arthritis: associations with pain, fatigue, depression, and disease activity. Clin Exp Rheumatol 2011; 29(6 Suppl 69):S92-6.

Munguía-Izquierdo D, Legaz-Arrese A. Determinants of sleep quality in middle-aged women with fibromyalgia syndrome. J Sleep Res 2012;21(1):73-9.

Osorio CD, Gallinaro AL, Lorenzi-Filho G, Lage LV. Sleepquality in patients with fibromyalgia using the Pittsburgh Sleep Quality Index. J Rheumatol 2006;33(9):1863-5.

Wolfe F. The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic. Ann Rheum Dis 1997;56(4):268-71.

Kurland JE, Coyle WJ, Winkler A, Zable E. Prevalence of irritable bowel syndrome and depression in fibromyalgia. Dig Dis Sci 2006;51(3):454-60.

Bigatti SM, Hernandez AM, Cronan TA, Rand KL. Sleep disturbances in fibromyalgia syndrome: relationship to pain and depression. Arthritis Rheum 2008;59(7):961-7.

Nicassio PM, Moxham EG, Schuman CE, Gevirtz RN. The contribution of pain, reported sleep quality, and depressive symptoms to fatigue in fibromyalgia. Pain 2002;100(3):271-9.