Fibromyalgia burden significant in patients with comorbid insomnia
Fibromyalgia patients with comorbid insomnia more often receive prescription medications for fibromyalgia and use ambulatory care services relative to their counterparts without the sleep disorder, according to a study, suggesting that comorbidity with insomnia substantially increases its burden.
Researchers used data from the Longitudinal Health Insurance Database 2010 and analysed the medical records of 17,920 patients treated for fibromyalgia, among whom 5,466 had comorbid insomnia. Compared with those who had no comorbidity, those who did had higher ambulatory visits and costs per person-year for evaluating or treating fibromyalgia and other conditions. Interestingly, most of the ambulatory visits were for treating other conditions other than fibromyalgia.
Multivariable logistic regression analysis revealed comorbid insomnia to be associated with higher likelihood of future use of antidepressants (adjusted odds ratio (OR), 3.84; p<0.001), gabapentin (adjusted OR, 1.67; p<0.001), pregabalin (adjusted OR, 1.79; p=0.046), muscle relaxants (adjusted OR, 3.05; p<0.001), and opioids and tramadol (adjusted OR, 1.59; p<0.001).
Additionally, the presence of sleep disorder was associated with greater frequency of visits to ambulatory care services for both fibromyalgia (β, 1.79, 95 percent CI, 1.57–2.02; p<0.001) and other conditions (β, 108.51, 103.14–113.89; p<0.001).
Poor sleep may aggravate symptom distress and pain intensity in fibromyalgia patients, leading to an increase in the economic burden on the healthcare system, according to the researchers. This highlights the importance of effective management of sleep disturbances in the management of this population.