Background Sleep disturbance as well as anxiety and depression may play one of the main roles in a chronic pain maintenance in fibromyalgia (FM), though may be secondary to chronic pain presence. FM patients experience a number of different sleep-related problems including obstructive sleep apnea (OSA) and restless legs syndrome (RLS).

Objectives The purpose of this study was to investigate the prevalence of sleep-related conditions, such as OSA and RLS and to explore the association with anxiety and depression severity in FM patients.

Methods The study involved 63 FM patients (ACR 1990 criteria) aged 54.3±4.7 (M±SD) yrs and 32 healthy controls (HCs) aged 49.8±5.3 yrs. Depression and anxiety were assessed according to Hamilton Depression Rating Scale (HAM-D) (Hamilton M., 1960) and Hamilton Anxiety Rating Scale (HAM-A) (Hamilton M., 1959). OSA was screened by Haraldsson's questionnaire (Haraldsson PO et all, 1992) and the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) (Weatherwax KJ et al, 2003). The 2003 IRLSSG criteria originally listed four essential criteria to clinically diagnose RLS with a 2011 revision adding a fifth criteria.

Results OSA was revealed in 21 FM patients (33.3%) and RLS was diagnosed in 11 FM patients (17.5%). OSA was detected in 1 HC (3.1%). None of HCs was found to have RLS. According to (HAM-D) results 35 FM patients (55.6%) had mild depression, and none of HCs was revealed to have depression. Further analysis detected more severe depression in FM patients with OSA than in FM patients without concomitant OSA (11.2±2.7 vs. 5.4±2.1, p<0.05). Anxiety was found in 32 FM patients (50.8%). Among HCs 3 persons (9.4%) were detected to have anxiety (12.7±1.8). According to (HAM-A) results FM patients with RLS had moderate to severe anxiety, while FM patients without RLS had mild to moderate anxiety (28.2±2.9 vs. 17.3±2.4, p<0.05).

Conclusions Sleep-related disorders such as OSA and RLS are present in 33.3 and 17.5% FM patients accordingly. RLS presence is associated with increase of anxiety level, while OSA is related with increase of depression severity in FM patients.

References

1. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62

2. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32:50–55.

3. Haraldsson PO, Carenfelt C, Knutsson E, Persson HE, Rinder J. Preliminary report: validity of symptom analysis and daytime polysomnography in diagnosis of sleep apnea. Sleep 1992;15:261-263.

4. R.P. Allen, D. Picchietti, W.A. Hening et al., Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health, Sleep Medicine, vol. 4, no. 2, pp. 101–119, 2003.

5. Restless Legs Foundation, February 2013, http://www.rls.org/.

6. Weatherwax KJ, Lin X, Marzec ML, et al. Obstructive sleep apnea in epilepsy patients: the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) is a useful screening instrument for obstructive sleep apnea in a disease-specific population. Sleep Med. 2003;4:517–521.

7. Wolfe F, Smythe HA, Yunus MB et all. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum1990;33:160–72.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.4359