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

Edwin S Meresh,1 Hewa Artin,2 Cara Joyce,3 Steven Birch,4 David Daniels,1 Jack H Owens,1 Alvaro J La Rosa,1 Murali S Rao,1 Angelos Halaris11Department of Psychiatry, Loyola University Medical Center, Maywood, IL 60153, USA; 2Loyola Stritch School of Medicine, Maywood, IL 60153, USA; 3Biostatistics C...

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Autores principales:	Meresh ES, Artin H, Joyce C, Birch S, Daniels D, Owens JH, La Rosa AJ, Rao MS, Halaris A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Fibromyalgia Obstructive Sleep Apnea Co-morbidity Sleep Rheumatology Psychiatry Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/36a06c6d6d0d42d3996bf4afab448003
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spelling	oai:doaj.org-article:36a06c6d6d0d42d3996bf4afab4480032021-12-02T09:31:48ZObstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review1179-156Xhttps://doaj.org/article/36a06c6d6d0d42d3996bf4afab4480032019-04-01T00:00:00Zhttps://www.dovepress.com/obstructive-sleep-apnea-co-morbidity-in-patients-with-fibromyalgia-a-s-peer-reviewed-article-OARRRhttps://doaj.org/toc/1179-156XEdwin S Meresh,1 Hewa Artin,2 Cara Joyce,3 Steven Birch,4 David Daniels,1 Jack H Owens,1 Alvaro J La Rosa,1 Murali S Rao,1 Angelos Halaris11Department of Psychiatry, Loyola University Medical Center, Maywood, IL 60153, USA; 2Loyola Stritch School of Medicine, Maywood, IL 60153, USA; 3Biostatistics Core, Clinical Research Office, Loyola University Medical Center, Maywood, IL 60153, USA; 4Informatics and Systems Development, Loyola University Medical Center, Maywood, IL 60153, USABackground: 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.Keywords: fibromyalgia, obstructive sleep apnea, co-morbidity, sleep, rheumatology, psychiatryMeresh ESArtin HJoyce CBirch SDaniels DOwens JHLa Rosa AJRao MSHalaris ADove Medical PressarticleFibromyalgiaObstructive Sleep ApneaCo-morbiditySleepRheumatologyPsychiatryDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 11, Pp 103-109 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fibromyalgia Obstructive Sleep Apnea Co-morbidity Sleep Rheumatology Psychiatry Diseases of the musculoskeletal system RC925-935
spellingShingle	Fibromyalgia Obstructive Sleep Apnea Co-morbidity Sleep Rheumatology Psychiatry Diseases of the musculoskeletal system RC925-935 Meresh ES Artin H Joyce C Birch S Daniels D Owens JH La Rosa AJ Rao MS Halaris A Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review
description	Edwin S Meresh,1 Hewa Artin,2 Cara Joyce,3 Steven Birch,4 David Daniels,1 Jack H Owens,1 Alvaro J La Rosa,1 Murali S Rao,1 Angelos Halaris11Department of Psychiatry, Loyola University Medical Center, Maywood, IL 60153, USA; 2Loyola Stritch School of Medicine, Maywood, IL 60153, USA; 3Biostatistics Core, Clinical Research Office, Loyola University Medical Center, Maywood, IL 60153, USA; 4Informatics and Systems Development, Loyola University Medical Center, Maywood, IL 60153, USABackground: 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.Keywords: fibromyalgia, obstructive sleep apnea, co-morbidity, sleep, rheumatology, psychiatry
format	article
author	Meresh ES Artin H Joyce C Birch S Daniels D Owens JH La Rosa AJ Rao MS Halaris A
author_facet	Meresh ES Artin H Joyce C Birch S Daniels D Owens JH La Rosa AJ Rao MS Halaris A
author_sort	Meresh ES
title	Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review
title_short	Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review
title_full	Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review
title_fullStr	Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review
title_full_unstemmed	Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review
title_sort	obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/36a06c6d6d0d42d3996bf4afab448003
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Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review

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