SAT0399 Sleep Disorders and its Influence on Cognitives Disturbances in Patients with Fibromyalgia
Authors: C. Galisteo, M. Larrosa, M. J. Masdeu, M. Jodar, M. Garcia-Manrique, E. Casado, J. Gratacos
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> To evaluate sleep disorders in patients with FM and its potential association with cognitive impairment and disease severity <h3>Methods</h3> 30 female patients with FM(ACR’90 criteria), 30 female patients with CP(non-oncological) and without depression, and 30 healthy female volunteers were included in a cross-sectional study. Inclusion criteria: postmenopausal women, BMI&lt;34,9 kg/m². Exclusion criteria: comorbility, drugs potentially affecting central or autonomic nervous systems. Variables assessed: 1)demographic, anthropometric variables and education level. Depression test. 2)Nocturnal polysomnography assessing: a)neurologic variables: sleep latency (minutes to get to sleep), efficiency (% sleep time vs. time in bed), presence of cyclic alternating pattern(CAP) and hypnogram (sleep phases); and b) respiratory variables: presence of apneas/hypopneas, respiratory efforts related arousal (RERA) and inspiratory airflow limitation(hours of sleep with inspiratory flow limitation(normal &lt;30%). 3) Neurocognitive study(10 questionnaires)assessing : attention(sustained, divided and selective), verbal memory and visual memory (working memory, learning ability, short- and long-term retention and logic memory) and information processing speed; and 4) Tender point count (out of 18) and Fibromyalgia Impact Questionnaire (FIQ) in patients with FM. <h3>Results</h3> Patients with FM:1) Age 53.8±3.2 y (p= ns vs. other groups); no differences regarding other variables. 2)Polysomnography a)Neurologic variables:&gt;latency (32.5±25.1 min) and&lt;sleep efficiency (76.6±11.9) compared to healthy volunteers (p =0.04 and p =0.028, respectively) and without differences versus CP patients;&gt;presence of CAPs (60.2 ±9.9) compared with CP patients and healthy female (p=0.04 and p=0.003, respectively); no differences in hypnogram. b) Respiratory variables: no differences between groups regarding the presence of apneas/hypopneas;&gt;RERA compared to CP patients and healthy female; presence of inspiratory flow limitation in 46% of FM patients, 11.7% of CP patients and 3% of healthy female with &gt;sleep time with such limitation 51% sleep hours in FM patients vs. 36% in CP patients, and more severe in FM (30 ±22%) than in CP patients (14.7 ±12,8%) and healthy female (9 ±10.2%) (p =0.004 and p =0.001, respectively). These sleep disorders were associated with a greater overall sleep fragmentation only in the FM group (p =0.04). There was a significant relation between sleep and cognitive variables in the FM group: sleep latency and visual attention (p=0.01); sleep efficiency and attention capacity (p &lt;0.02), scanning speed (p =0.01) and visual processing (p =0.01) and inspiratory flow limitation and recent verbal memory (p &lt;0.05). No significant relation with tender point count or FIQ was found. <h3>Conclusions</h3> The neurologic impairments detected by polysomnography agree with the already reported in the literature. We have detected an inspiratory flow limitation in FM patients, due to a greater airway resistance, which could explain the poor sleep quality in these patients and which could also be involved in the cognitive deficits/impairments FM patients suffer. <h3>Acknowledgements</h3> Funding: Marató TV3 grant <h3>Disclosure of Interest</h3> None Declared