The Correlation of Pain, Psychological Aspects, and Sleep in Fibromyalgia: A Cross-Sectional Analysis

Edwin S Meresh; Sarah Xu; Angelina Palomino; Hewa Artin; Julia Padiyara; Conrad Stasieluk; Abid Khurshid

doi:10.2147/OARRR.S438931

The Correlation of Pain, Psychological Aspects, and Sleep in Fibromyalgia: A Cross-Sectional Analysis

Open Access Rheumatol. 2023 Dec 19:15:237-246. doi: 10.2147/OARRR.S438931. eCollection 2023.

Authors

Edwin S Meresh¹, Sarah Xu², Angelina Palomino², Hewa Artin², Julia Padiyara³, Conrad Stasieluk¹, Abid Khurshid⁴

Affiliations

¹ Department of Psychiatry, Loyola University Medical Center, Maywood, IL, 60153, USA.
² Loyola Stritch School of Medicine, Maywood, IL, 60153, USA.
³ Loyola Medicine Center for Sleep Disorders, Loyola University Medical Center, Maywood, IL, 60153, USA.
⁴ Pulmonary Medicine, Loyola University Medical Center, Maywood, IL, 60153, USA.

Abstract

Background: This pilot study measures pain perception, somatosensory amplification and its relationship to health anxiety in patients with fibromyalgia (FM) and patients with FM and obstructive sleep apnea (OSA); this study also examines the effects of OSA on pain perception in patients with FM.

Methods: In this pilot study, patients diagnosed with FM or FM and OSA, completed three self-reported questionnaires: Short-Form McGill Pain Questionnaire (SF-MPQ), Somatosensory Amplification Scale (SSAS), and Illness Behavior Questionnaire (IBQ). Sleep study results were analyzed. Scores were summarized using medians and interquartile ranges and are compared using Wilcoxon rank sum tests.

Results: Overall FM (n = 25), female n=23 male n=3 mean age, 57.48 years. OSA n=17 (68%) and 8 (32%) were not. The SF-MPQ Sensory sub-scale scores and the SF-MPQ overall scores differed significantly between patients with and without OSA. The SF-MPQ Sensory sub-scale scores were significantly lower for patients with OSA (p=0.03), as were SF-MPQ overall scores (p=0.04). SSAS overall scores and IBQ overall scores did not differ significantly by OSA diagnosis. Correlations of the different dimensions of IBQ with SSAS and mean number of diagnoses in FM and FM+OSA, mean number of diagnoses in problem list of SSAS ≤30 was 29.5, mean number of diagnoses in SSAS ≥30 was 34.9.

Discussion: Developing a better understanding of the effects of OSA on pain perception in patients with FM is needed for improved health status. More research is needed to see if higher pain perception and SSAS score lead to increased health care utilization and to evaluate the relationship between untreated disordered sleeping and pain perception in patients with FM.

Conclusion: Our findings highlight the need for more research to evaluate the relationship between treated and untreated disordered sleeping, pain perception, somatization and illness behavior in the health status of individuals with FM.

Keywords: fibromyalgia; illness behavior; obstructive sleep apnea; pain perception; symptom amplification.