Donald F, Esdaile J M, Kimoff J R, Fitzcharles M A
Rheumatic Diseases Unit, McGill University, Montreal, Quebec, Canada.
J Rheumatol. 1996 Sep;23(9):1612-6.
To determine the frequency of fibromyalgia (FM) syndrome and reporting of pain in an unselected group of patients attending a respiratory sleep disorders clinic, and to examine the association of physical activity and levels of reported pain.
108 consecutive patients attending a respiratory sleep disorders clinic were interviewed and examined, blind to sleep disorder status. Assessment of musculoskeletal pain symptoms included patient history of pain, painful sites marked on a mannequin, visual analog scale (VAS) pain score, and tender point count. Daily physical activity was recorded, and all patients underwent nocturnal polysomnography, blind to clinical status.
FM was identified in 3 patients (2.7%). Pain reporting was more strongly associated with reduced physical activity than with a specific sleep disorder. Patients with reduced physical activity were more likely to have pain symptoms than physically active patients: tender point count > or = 6 (p = 0.002), > or = 3 sites marked on mannequin (p = 0.008), axial pain (p = 0.003), and VAS pain score (p = 0.008).
FM by defined criteria was uncommon in patients with a primary complaint of disturbed sleep, and in particular, patients with sleep apnea. Reduced physical activity was strongly associated with reported pain symptoms.
确定在一家呼吸睡眠障碍诊所就诊的未经挑选的患者群体中纤维肌痛（FM）综合征的发生率及疼痛报告情况，并研究身体活动与报告的疼痛程度之间的关联。
对一家呼吸睡眠障碍诊所的108例连续就诊患者进行了访谈和检查，检查者对睡眠障碍状况不知情。对肌肉骨骼疼痛症状的评估包括患者疼痛病史、在人体模型上标记的疼痛部位、视觉模拟量表（VAS）疼痛评分以及压痛点计数。记录每日身体活动情况，所有患者均接受夜间多导睡眠图检查，检查者对临床状况不知情。
3例患者（2.7%）被诊断为FM。疼痛报告与身体活动减少的关联比与特定睡眠障碍的关联更强。身体活动减少的患者比身体活动活跃的患者更有可能出现疼痛症状：压痛点计数≥6（p = 0.002）、在人体模型上标记≥3个部位（p = 0.008）、轴向疼痛（p = 0.003）以及VAS疼痛评分（p = 0.008）。
根据既定标准，FM在以睡眠障碍为主诉的患者中并不常见，尤其是在睡眠呼吸暂停患者中。身体活动减少与报告的疼痛症状密切相关。
