ORIJINAL ARAŞTIRMA
Obstrüktif Uyku Apne Sendromu Tanısı Olanlar ile Olmayanlar Arasında Fibromiyalji Sendromu Sıklığının Karşılaştırılması
Comparison of the Frequency of Fibromyalgia Syndrome Between Those with and Without Obstructive Sleep Apnea Syndrome
Received Date : 24 Jun 2022
Accepted Date : 04 Dec 2022
Available Online : 08 Dec 2022
Mehmet OKÇUa, Figen TUNCAYb, Arzu ERTÜRKc, Samet Sancar KAYAb
aDepartment of Physical Medicine and Rehabilitation, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
bDepartment of Physical Medicine and Rehabilitation, Kırşehir Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye
cDepartment of Chest Disease, Kırşehir Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye
Doi: 10.31609/jpmrs.2022-92113 - Makale Dili: EN
J PMR Sci. 2023;26(1):80-6
ÖZET
Amaç: Uyku bozukluğunun, fibromiyalji sendromunun (FMS) etyopatogenezinde
önemli rol aldığı bildirilmiştir. Bu çalışmada uyku bozukluğu
ile karakterize bir hastalık olan obstrüktif uyku apne sendromu (OUAS)
olan ve olmayan hastalarda, FMS sıklığının belirlenmesi amaçlanmıştır. Ayrıca
polisomnografi parametrelerinin FMS ile ilişkinin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya 20 OUAS’lı katılımcı (OUAS
grubu) ile OUAS’ı olmayan 20 katılımcı (kontrol grubu) dahil edildi. Tüm
katılımcılar Amerika Romatoloji Cemiyeti FMS kriterleri ile FMS tanısı
açısından değerlendirildi. Tüm katılımcıların kronik yaygın ağrıları, Sayısal
Derecelendirme Ölçeği ile; depresyon düzeyleri Beck Depresyon Envanteri
(BDE) ile; anksiyete düzeyleri Beck Anksiyete Envanteri (BAE) ile değerlendirildi.
OUAS’lı hastaların polisomnografi parametreleri kaydededildi.
Bulgular: İki grup yaş, cinsiyet ve vücut kitle indeksi gibi demografik veriler
açısından benzerdi. OUAS grubunda FMS tanılı hasta sayısı, hastaların
kronik yaygın ağrı Sayısal Derecelendirme Ölçeği düzeyi, BAE skoru,
kronik ağrı süresi kontrol grubuna göre anlamlı olarak daha yüksek olarak
tespit edildi. Her iki grubun BDE skorları benzerdi. OUAS grubundaki hastalardan
FMS’li hastalar ile FMS tanısı olmayan hastalar arasında polisomnografi
parametreleri açısından anlamlı bir fark testpit edilmedi. Sonuç: Bu
çalışmada OUAS'lı hastalardaki FMS sıklığı OUAS'ı olmayanlara göre daha
yüksekti. FMS’li ve OUAS'lı hastaları değerlendirirken bu birliktelik akılda
tutulmalıdır. Ayrıca bu çalışmada FMS varlığının OUAS’lı hastaların polisomnografi
parameterlerini etkilemediği tespit edilmiştir.
Anahtar Kelimeler: Obstrüktif uyku apnesi; fibromiyalji; ağrı; uyku
ABSTRACT
Objective: Sleep disturbance plays an important role in the
etiopathogenesis of fibromyalgia syndrome (FMS). This study aimed to
compare the frequency of FMS between those with and without obstructive
sleep apnea syndrome (OSAS). In addition, it was aimed to examine the relationship
between polysomnography parameters and FMS. Materials and
Methods: Twenty participants with OSAS (OSAS group) and 20 participants
without OSAS (control group) were included in the study. All participants
were evaluated for FMS diagnosis using the American College of
Rheumatology FMS criteria. The chronic widespread pain levels of all participants
were evaluated by the Numerical Rating Scale (NRS), their depression
levels were evaluated by the Beck Depression Inventory (BDI),
and their anxiety levels were evaluated by the Beck Anxiety Inventory
(BAI). Results: The number of patients diagnosed with FMS, chronic
widespread pain NRS levels, BAI scores, and chronic pain durations of the
patients in the OSAS group were found to be significantly higher than in
the control group. BDI scores of both groups were similar. Among the patients
in the OSAS group, no significant difference was detected in terms of
polysomnography parameters between patients with FMS and patients without
FMS. Conclusion: In this study, the frequency of FMS in patients with
OSAS was higher than in those without OSAS. This association should be
kept in mind when evaluating patients with FMS and OSAS. In addition, in
this study, it was determined that the presence of FMS did not affect the
polysomnography parameters of patients with OSAS.
Keywords: Obstructive sleep apnea; fibromyalgia; pain; sleep
REFERENCES
- Siracusa R, Paola RD, Cuzzocrea S, et al. Fibromyalgia: pathogenesis, mechanisms, diagnosis and treatment options update. Int J Mol Sci. 2021;22:3891. [Crossref] [PubMed] [PMC]
- Faber J, Faber C, Faber AP. Obstructive sleep apnea in adults. Dental Press J Orthod. 2019;24:99-109. [Crossref] [PubMed] [PMC]
- Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14:1539-52. [Crossref] [PubMed] [PMC]
- Mundal I, Gråwe RW, Bjørngaard JH, et al. Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study. BMC Musculoskelet Disord. 2014;15:213. [Crossref] [PubMed] [PMC]
- Haack M, Sanchez E, Mullington JM. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Sleep. 2007;30:1145-52. [Crossref] [PubMed] [PMC]
- Irwin MR, Olmstead R, Carrillo C, et al. Sleep loss exacerbates fatigue, depression, and pain in rheumatoid arthritis. Sleep. 2012;35:537-43. [Crossref] [PubMed] [PMC]
- Smith MT, Edwards RR, McCann UD, et al. The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep. 2007;30:494-505. [Crossref] [PubMed]
- Zorlu D, Ozyurt S, Bırcan HA, et al. Do complete blood count parameters predict diagnosis and disease severity in obstructive sleep apnea syndrome? Eur Rev Med Pharmacol Sci. 2021;25:4027-36. [PubMed]
- Hjermstad MJ, Fayers PM, Haugen DF, et al; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011;41:1073-93. [Crossref] [PubMed]
- Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S467-72. [Crossref] [PubMed] [PMC]
- Richter P, Werner J, Heerlein A, et al. On the validity of the Beck Depression Inventory. A review. Psychopathology. 1998;31:160-8. [Crossref] [PubMed]
- Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of Cognitive Psychotherapy. 1998;12:163-72. [Link]
- Tekindal M, Tekindal MA. Validity and Reliability of Basic Depression Scale for Turkey. Med J West Black Sea. 2021;5:452-63. [Crossref]
- Yeşilyurt M, Faydalı S. [Use of one-dimensional scales in pain assessment]. Journal of Anatolia Nursing and Health Sciences. 2020;23:444-51. [Crossref]
- Terzi R, Yılmaz Z. Evaluation of pain sensitivity by tender point counts and myalgic score in patients with and without obstructive sleep apnea syndrome. Int J Rheum Dis. 2017;20:340-5. [Crossref] [PubMed]
- Atan T, Atan D. [Comparison of polysomnography parameters and functional status of patients with fibromyalgia and obstructive sleep apnea syndrome]. Kocaeli Medical Journal. 2020;9:131-5. [Crossref]
- Yildirim T, Alp R. The role of oxidative stress in the relation between fibromyalgia and obstructive sleep apnea syndrome. Eur Rev Med Pharmacol Sci. 2017;21:20-9. [PubMed]
- Altıntop Geçkil A, Aydoğan Baykara R. Coexistence of obstructive sleep apnea syndrome and fibromyalgia. Tuberk Toraks. 2022;70:37-43. [Crossref] [PubMed]
- Köseoğlu Hİ, İnanır A, Kanbay A, et al. Is there a link between obstructive sleep apnea syndrome and fibromyalgia syndrome? Turk Thorac J. 2017;18:40-6. [Crossref] [PubMed] [PMC]
- Çetin B, Sünbül EA, Toktaş H, et al. Comparison of sleep structure in patients with fibromyalgia and healthy controls. Sleep Breath. 2020;24:1591-8. [Crossref] [PubMed]
- Marvisi M, Balzarini L, Mancini C, et al. Fibromyalgia is frequent in obstructive sleep apnea and responds to CPAP therapy. Eur J Intern Med. 2015;26:e49-50. [Crossref] [PubMed]
- Türk AÇ. [Old and new criteria for the diagnosis of fibromyalgia: comparison and evaluation]. Ankara Med J. 2019;19:83-95. [Link]
- Sarzi-Puttini P, Giorgi V, Marotto D, et al. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020;16:645-60. [Crossref] [PubMed]
- Moldofsky H, Scarisbrick P, England R, et al. Musculosketal symptoms and non-REM sleep disturbance in patients with "fibrositis syndrome" and healthy subjects. Psychosom Med. 1975;37:341-51. [Crossref] [PubMed]
- Choy EH. The role of sleep in pain and fibromyalgia. Nat Rev Rheumatol. 2015;11:513-20. [Crossref] [PubMed]
- Rizzi M, Sarzi-Puttini P, Atzeni F, et al. Cyclic alternating pattern: a new marker of sleep alteration in patients with fibromyalgia? J Rheumatol. 2004;31:1193-9. [PubMed]
- Rodriguez-Pintó I, Agmon-Levin N, Howard A, et al. Fibromyalgia and cytokines. Immunol Lett. 2014;161:200-3. [Crossref] [PubMed]
- Lanfranco F, Motta G, Minetto MA, et al. Growth hormone/insulin-like growth factor-I axis in obstructive sleep apnea syndrome: an update. J Endocrinol Invest. 2010;33:192-6. [Crossref] [PubMed]
- Bennett RM. Adult growth hormone deficiency in patients with fibromyalgia. Curr Rheumatol Rep. 2002;4:306-12. [Crossref] [PubMed]
- Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230-5. [Crossref] [PubMed]