Coexistência de transtornos respiratórios do sono e síndrome fibromiálgica Sleep disordered breathing concomitant with fibromyalgia syndrome

OBJETIVO: Identificar síndrome fibromiálgica em pacientes com transtornos respiratórios do sono. MÉTODOS: Foram estudados 50 pacientes que compareceram à Clínica do Sono com queixas de roncar no sono, apnéias e sonolência diurna. Confirmou-se o diagnóstico de transtornos respiratórios do sono através de polissonografia. Para se estabelecer o diagnóstico de síndrome fibromiálgica, submeteram-se os pacientes a avaliação de acordo com os critérios estabelecidos pelo American College of Rheumatology. RESULTADOS: Estudaram-se 50 pacientes, 32 do sexo masculino. A média (&plusmn; desvio-padrão) de idade do grupo foi de 50 &plusmn; 12 anos. A média do índice de massa corporal do grupo foi de 29,7 &plusmn; 5,6 kg/m². A média do índice de apnéias e hipopnéias do grupo foi de 36 &plusmn; 29 apnéias e hipopnéias /hora. Nove das 18 mulheres e 2 homens preencheram os critérios estabelecidos pelo American College of Rheumatology para o diagnóstico de síndrome fibromiálgica. CONCLUSÃO: Considerando-se que a prevalência de síndrome fibromiálgica na população geral é de 0,5% para homens e de 3,4% para mulheres, a fração de casos de fibromialgia mais de dez vezes maior nesta amostra reforça a hipótese de associação entre transtornos respiratórios do sono e síndrome fibromiálgica.<br>OBJECTIVE: To identify fibromyalgia syndrome in patients with sleep disordered breathing. METHOD: We studied 50 patients seeking treatment at a sleep disorder clinic for snoring, apnea and excessive daytime sleepiness. Sleep disordered breathing was diagnosed through the use of polysomnography. To diagnose fibromyalgia syndrome, patients were evaluated in accordance with the criteria established by the American College of Rheumatology. RESULTS: Of the 50 patients, 32 were male. The mean (&plusmn; standard deviation) age of the group was 50 &plusmn; 12 years. The mean body mass index was 29.7 &plusmn; 5.6 kg/m². The mean apnea-hypopnea index was 36 &plusmn; 29 attacks of apnea or hypopnea per hour of sleep. Of the 18 women and 32 men evaluated, 9 and 2, respectively, met the American College of Rheumatology criteria for fibromyalgia syndrome. CONCLUSION: Considering the fact that the prevalence of fibromyalgia syndrome in the general population is 0.5% for men and 3.4% for women, the more than ten-fold higher proportion of fibromyalgia cases seen in this sample supports the hypothesis that there is an association between sleep disordered breathing and fibromyalgia syndrome

Sleep and chronic pain

Chronic pain can be unrelenting. Unlike acute pain for which therapies could provide relief, chronic pain can seldom be cured. Persistent pain often impairs functioning. It may be surprising but chronic pain patients’ quality of life has been found to be lower than those of patients with chronic illnesses (e.g., chronic obstructive pulmonary disease) or life-threatening diseases (e.g., HIV/AIDS). While some individuals manage to live fulfilling lives despite pain, others suffer both physically and mentally and go on to develop anxiety, depression, and even increased suicidal ideation and behavior. One plausible reason is that, to many chronic pain patients, pain is not the only source of distress and disability. Among the many other concomitant health and emotional problems, sleep (or the lack of it) is a particular area with which most chronic pain patients want help