Effect of Positive Airway Pressure Therapy on Fibromyalgia Symptoms in Obstructive Sleep Apnea Syndrome

Purpose Fibromyalgia syndrome (FMS) is characterized by fatigue, sleep disturbances, and idiopathic pain symptoms. Obstructive sleep apnea syndrome (OSAS) is defined by recurrent episodes of upper airway obstruction and decreases in arterial oxygen saturation during sleep. In this study, we investigated the effect of positive airway pressure (PAP) therapy on FMS symptoms in patients with the coexistence of OSAS and FMS. Methods There were a total of 370 participants with a polysomnographic (PSG) diagnosis of OSAS, who were prescribed PAP device. All off the partipicants were questioned according to the American College of Rheumatology (ACR) 2010 diagnostic criteria for fibromyalgia at the physical therapy and rehabilitation clinic. The study was conducted with 85 of these individuals who had a concomitant diagnosis of FMS with same scoring system. Before and at the sixth month of treatment, telemedicine and in-person assessments were performed in patients with OSAS and FMS. The Fibromyalgia Impact Questionnaire (FIQR) scores (0–100 points) and weekly PAP device usage hours were determined. Results A total of 85 patients were included in the study. The prevalence of FMS was 22.9% in severe-moderate OSAS. No significant correlation identified, between the FIQR score before PAP therapy and apnea–hypopnea index (AHİ), mean oxygen saturation, minimum oxygen saturation, duration of oxygen saturation below 90 percent (desaturation time) and sleep efficiency. There was a moderate negative correlation between the FIQR score after 6 months of PAP treatment and weekly PAP usage hours. Conclusion Patients with FMS should be evaluated for OSAS since these two conditions may coexist. PAP therapy is not a recommended treatment modality for isolated FMS, it is gold standard established treatment for OSAS. An additional benefit of PAP usage in OSAS patients who have concomitant FMS is a decreased severity of fibromyalgia symptoms.