Chahine Abdallah, El Zouki Christian-Joseph, Al Khoury Ghida, Obeid Sahar, Fekih-Romdhane Feten, Mansour Marielle, Lahoud Jean-Claude, Hallit Souheil
School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
UFR de Médecine, Université de Picardie Jules Verne, Amiens, 80000, France.
Open Access Rheumatol. 2025 Sep 12;17:203-219. doi: 10.2147/OARRR.S530912. eCollection 2025.
Several studies have emerged to understand the relationship between insomnia and mental health issues like depression and anxiety from a causative perspective. Lebanon is a small country tormented by war, social insecurities and economic challenges, making it the fertile ground to understand the interaction between these variables in this population, especially with chronic pain. This study aims to better understand the relationship between insomnia, depression and anxiety in fibromyalgia patients in the Lebanese context.
This cross-sectional study was conducted from October to November 2024 and involved participants from all over Lebanon. The questionnaire included sociodemographic questions and scales including the Widespread pain index (WPI), Symptom severity scale (SSS), Patient Health Questionnaire (PHQ-4) and Insomnia Severity Index (ISI).
The analysis showed that Insomnia mediated the association between fibromyalgia and depression; higher fibromyalgia was significantly associated with higher insomnia severity, whereas higher insomnia severity was associated with higher depression. Also, Insomnia mediated the association between fibromyalgia and anxiety; higher fibromyalgia was significantly associated with higher insomnia severity, whereas higher insomnia severity was associated with higher anxiety. However, depression and anxiety did not mediate the association between fibromyalgia and insomnia severity.
This study focused on the mediating role of insomnia between fibromyalgia and development of depression and anxiety on a sample of 641 Lebanese individual. With the use of specific scales and guidelines of the American College of Rheumatology, we were able to clearly elucidate the relationship between the selected variables. These findings underscore the importance of addressing issues such as insomnia in chronic pain as well as the associated comorbidities which have been proven to play an important role in the course of the disease. Future research should further explore targeted interventions that could enhance overall wellbeing in individuals with FM, considering the multiple factors influencing one's condition.
已经出现了几项研究，从因果关系的角度来理解失眠与抑郁症和焦虑症等心理健康问题之间的关系。黎巴嫩是一个饱受战争、社会不安全和经济挑战折磨的小国，这使其成为了解这些变量在该人群中相互作用的理想之地，尤其是与慢性疼痛相关的相互作用。本研究旨在更好地了解黎巴嫩背景下纤维肌痛患者中失眠、抑郁和焦虑之间的关系。
这项横断面研究于2024年10月至11月进行，参与者来自黎巴嫩各地。问卷包括社会人口学问题和量表，包括广泛性疼痛指数（WPI）、症状严重程度量表（SSS）、患者健康问卷（PHQ - 4）和失眠严重程度指数（ISI）。
分析表明，失眠介导了纤维肌痛与抑郁之间的关联；较高的纤维肌痛与较高的失眠严重程度显著相关，而较高的失眠严重程度与较高的抑郁相关。此外，失眠介导了纤维肌痛与焦虑之间的关联；较高的纤维肌痛与较高的失眠严重程度显著相关，而较高的失眠严重程度与较高的焦虑相关。然而，抑郁和焦虑并未介导纤维肌痛与失眠严重程度之间的关联。
本研究聚焦于失眠在641名黎巴嫩个体样本中纤维肌痛与抑郁和焦虑发展之间的中介作用。通过使用美国风湿病学会的特定量表和指南，我们能够清晰地阐明所选变量之间的关系。这些发现强调了在慢性疼痛中解决失眠等问题以及相关合并症的重要性，这些合并症已被证明在疾病过程中发挥重要作用。未来的研究应进一步探索有针对性的干预措施，考虑到影响个体状况的多种因素，以提高纤维肌痛患者的整体幸福感。
