Abstract
BackgroundDifficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM.MethodsThe current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables.ResultsOf the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population.ConclusionsAmong the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted.
Highlights
Difficulty sleeping is common among patients with fibromyalgia (FM); its impact on health-related quality of life (HRQoL) is not well understood
Even when comparing patients with FM with matched controls, the prevalence of sleep difficulty symptoms was significantly higher
Demographic and health history comparisons Among patients with FM, few demographic and health history variables were related to the number of sleep symptoms experienced
Summary
Difficulty sleeping is common among patients with fibromyalgia (FM); its impact on health-related quality of life (HRQoL) is not well understood. Often accompanied by non-specific symptoms, such as fatigue, depressive mood, and sleep difficulties [2], FM affects approximately 5 million Americans [3]. As it largely affects a working-age population, and is associated with increased resource use and disability, FM is responsible. In a recent review of 37 studies, Hoffman & Dukes found patients with FM report mental health-related quality of life (HRQoL) scores 1 standard deviation below the United States (US) population mean and physical HRQoL scores 2 standard deviations below the US population mean [7]. HRQoL among patients with FM have been found to be similar to or worse than patients with rheumatoid arthritis [8] and other pain conditions [7]
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