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

Authors

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

Document Type

Article

Publication Date

4-29-2019

Publication Title

Open Access Rheumatology: Research and Reviews

Volume

11

Pages

1-7

Publisher Name

Dove Medical Press Limited

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.

Comments

Author Posting © The Author(s), 2019. This article is posted here by permission of Dove Medical Press Limited for personal use and non-commercial redistribution. This article was published open access in Open Access Rheumatology: Research and Reviews, Vol. 11 (April 29, 2019), https://doi.org/10.2147/OARRR.S196576.

Recommended Citation

Meresh, Edwin S.; Artin, Hewa; Joyce, Cara; Birch, Steven; Daniels, David; Owens, Jack H.; La Rosa, Alvaro J.; Rao, Murali S.; and Halaris, Angelos, "Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review" (2019). Biostatistics Collaborative Core: Faculty Publications and Other Works. 43.
https://ecommons.luc.edu/biostatistics_facpubs/43

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Copyright Statement

© The Author(s), 2019.