Jennum P, Drewes A M, Andreasen A, Nielsen K D
Department of Clinical Neurophysiology, Hvidovre Hospital, University of Copenhagen, Denmark.
J Rheumatol. 1993 Oct;20(10):1756-9.
To evaluate sleep architecture and self-reported complaints in patients with fibromyalgia (FS). Forty patients and 10 age standardized healthy controls were included. All participants were women.
All patients and controls underwent a clinical examination and gave answers to a questionnaire. Polysomnography was done in 20 patients and in all controls.
The percent arousal time and arousal index were higher (p < 0.05 and < 0.01, respectively) among FS compared to controls, but no other differences were found in sleep architecture. Ten of the patients with FS and 2 controls showed an apnea-hypoapnea index above 5/h (NS). The arousal time and arousal index were higher in patients with apnea-hypoapnea index > or = 5 compared to controls with apnea-hypoapnea index < 5 [mean (SD)] [arousal time: 4.5 (3.2) vs 0.7 (0.7), p < 0.001, arousal index: 14.9 (10.8) vs 2.4 (3.7), p < 0.001]. In patients with FS with apnea-hypoapnea index < 5 the arousal time was higher (2.0 (1.2), p < 0.05) and arousal index marginally higher (5.6 (3.2), p = 0.07) compared to the controls. No other differences were found in sleep structure. Insomnia (difficulties falling asleep, maintaining sleep, early morning awakening), tiredness, mood, cognitive disturbances and muscular pain were all reported more commonly by patients with FS than controls. A subdivision of the patients with FS into those with apnea-hypoapnea index < 5 and apnea-hypoapnea index > or = 5 did not change these findings.
We conclude, that patients with FS show minor polysomnographic findings, with a higher occurrence of arousals. The arousals were in part explained by respiratory abnormalities. Patients with FS have several complaints, including insomnia. Some of these may relate to sleep fragmentation. Controlled studies are a requirement in investigations of sleep disorders in fibromyalgia.
评估纤维肌痛（FS）患者的睡眠结构及自我报告的不适症状。纳入40例患者及10例年龄标准化的健康对照者。所有参与者均为女性。
所有患者及对照者均接受临床检查并回答问卷。20例患者及所有对照者均进行了多导睡眠图检查。
与对照组相比，FS患者的觉醒时间百分比及觉醒指数更高（分别为p < 0.05和< 0.01），但在睡眠结构方面未发现其他差异。10例FS患者及2例对照者的呼吸暂停低通气指数高于5次/小时（无显著性差异）。呼吸暂停低通气指数≥5的患者与呼吸暂停低通气指数< 5的对照者相比，觉醒时间及觉醒指数更高[均值（标准差）][觉醒时间：4.5（3.2）对0.7（0.7），p < 0.001，觉醒指数：14.9（10.8）对2.4（3.7），p < 0.001]。呼吸暂停低通气指数< 5的FS患者与对照者相比，觉醒时间更高（2.0（1.2），p < 0.05），觉醒指数略高（5.6（3.2），p = 0.07）。在睡眠结构方面未发现其他差异。FS患者报告的失眠（入睡困难、维持睡眠困难、早醒）、疲劳、情绪、认知障碍及肌肉疼痛均比对照者更常见。将FS患者分为呼吸暂停低通气指数< 5和呼吸暂停低通气指数≥5两组，这些结果并未改变。
我们得出结论，FS患者多导睡眠图检查结果轻微，觉醒发生率更高。觉醒部分可由呼吸异常解释。FS患者有多种不适症状，包括失眠。其中一些可能与睡眠片段化有关。在纤维肌痛睡眠障碍的研究中需要进行对照研究。
