Fibromiyalji Sendromunda Otonom Disfonksiyonun Uyku Kalitesi Üzerine Etkisi

Yıl 2026, Cilt: 6 Sayı: 1, 358 - 370, 31.01.2026

Sevil Okan

https://doi.org/10.52369/togusagbilderg.1789911

https://izlik.org/JA27DK59HC

Öz

Amaç: Fibromiyalji Sendromu (FMS), yaygın ağrı, yorgunluk ve dinlendirici olmayan uyku ile karakterizedir. Otonom sinir sistemi düzensizliği, özellikle uyku bozukluğu olmak üzere bu semptomların şiddetinde rol oynayabilir. Bu çalışmanın amacı, FMS’li bireylerde otonom disfonksiyonun uyku kalitesi üzerine etkisini araştırmaktır.
Yöntem: Bu çalışma Ocak–Mayıs 2025 tarihleri arasında yürütülmüş kesitsel bir araştırmadır. Çalışmaya, ACR 2016 kriterlerine göre FMS tanısı almış 40 kadın hasta ile yaş ve cinsiyet açısından eşleştirilmiş 40 sağlıklı bireyden oluşan kontrol grubu dahil edilmiştir. Katılımcılara Pittsburgh Uyku Kalitesi İndeksi (PUKİ), Kompozit Otonom Semptom Skoru-31 (COMPASS-31) ve Fibromiyalji Etki Anketi (FIQ) uygulanmıştır.
Bulgular: FMS grubunun PUKİ, COMPASS-31 ve FIQ puanları kontrol grubuna kıyasla anlamlı derecede yüksek bulunmuştur (p<0,001). Regresyon analizinde COMPASS-31 puanının PUKİ puanının anlamlı bir yordayıcısı olduğu saptanmıştır (B=0,278, p<0,001). Ayrıca FMS grubunda COMPASS-31 ile PUKİ puanları arasında anlamlı pozitif korelasyon bulunmuştur (r=0,448, p<0,05).
Sonuç: Bu çalışma, FMS’li bireylerin sağlıklı bireylere kıyasla anlamlı düzeyde artmış otonom disfonksiyon ve bozulmuş uyku kalitesine sahip olduğunu ortaya koymuştur. Otonom disfonksiyon düzeyi arttıkça uyku kalitesinde belirgin bir düşüş gözlenmektedir. Bu bulgu, otonom sinir sistemi bozukluklarının FMS semptomlarının gelişiminde ve şiddetlenmesinde merkezi bir rol oynayabileceğini desteklemektedir.

Anahtar Kelimeler

Fibromiyalji Sendromu , Otonom Disfonksiyon , Uyku Kalitesi

Etik Beyan

Çalışma, Helsinki Bildirgesi’ne uygun olarak yürütülmüş ve Tokat Gaziosmanpaşa Üniversitesi Etik Kurulu tarafından onaylanmıştır (24-MOBAEK-069). Çalışmaya dahil edilen tüm katılımcılardan bilgilendirilmiş onam alınmıştır.

Destekleyen Kurum

yok

Teşekkür

yok

The Effect of Autonomic Dysfunction on Sleep Quality in Fibromyalgia Syndrome

https://izlik.org/JA27DK59HC

Öz

Objective: Fibromyalgia Syndrome (FMS) is characterized by widespread pain, fatigue, and non-restorative sleep. Dysregulation of the autonomic nervous system may play a role in the severity of these symptoms, particularly sleep impairment. This study aimed to investigate the effect of autonomic dysfunction on sleep quality in individuals with FMS.
Methods: The study is a cross-sectional study conducted between January and May 2025, including 40 female patients diagnosed with FMS according to the ACR 2016 criteria, and a control group of 40 healthy individuals matched for age and gender. Participants were administered the Pittsburgh Sleep Quality Index (PSQI), the Composite Autonomic Symptom Score-31 (COMPASS-31), and the Fibromyalgia Impact Questionnaire (FIQ).
Results: The FMS group had significantly higher PSQI, COMPASS-31, and FIQ scores compared to the control group (p<0.001). Regression analysis revealed that the COMPASS-31 score was a significant predictor of PSQI score (B=0.278, p<0.001). Additionally, a significant positive correlation was found between COMPASS-31 and PSQI scores in the FMS group (r=0.448, p<0.05).
Conclusion: This study revealed that FMS exhibit significantly increased levels of autonomic dysfunction and impaired sleep quality compared to healthy individuals. As the level of autonomic dysfunction increases, a significant decline in sleep quality is observed. This finding supports the notion that autonomic nervous system disorders may play a central role in the development and exacerbation of FMS symptoms.

Anahtar Kelimeler

Fibromyalgia Syndrome , Autonomic Dysfunction , Sleep Quality

Etik Beyan

The study was conducted according to the Declaration of Helsinki and was approved by the Ethical Board of Tokat Gaziosmanpaşa University (24-MOBAEK-069). Informed consent was obtained from all individual participants included in the study.

Destekleyen Kurum

none

Teşekkür

no

Kaynakça

• 1. Giorgi V, Sarzi-Puttini P, Pellegrino G, Sirotti S, Atzeni F, Alciati A, et al. Pharmacological Treatment of Fibromyalgia Syndrome: A Practice-Based Review. Curr Pain Headache Rep. Springer; 2024;28(12):1349–63.
• 2. Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, et al. AAPT Diagnostic Criteria for Fibromyalgia. J Pain. Churchill Livingstone; 2019;20(6):611–28.
• 3. Ladisa E, Abbatantuono C, Ammendola E, Tancredi G, Delussi M, Paparella G, et al. Combined Proxies for Heart Rate Variability as a Global Tool to Assess and Monitor Autonomic Dysregulation in Fibromyalgia and Disease-Related Impairments. Sensors. Multidisciplinary Digital Publishing Institute (MDPI); 2025;25(8):2618.
• 4. de Tommaso M, Vecchio E, Nolano M. The puzzle of fibromyalgia between central sensitization syndrome and small fiber neuropathy: a narrative review on neurophysiological and morphological evidence. Neurological Sciences. Springer-Verlag Italia s.r.l.;2022;43(3):1667–84.
• 5. Martínez-Lavín M. Fibromyalgia and small fiber neuropathy: the plot thickens! Clin Rheumatol. Springer London; 2018;37(12):3167–71.
• 6. Spaeth M, Rizzi M, Sarzi-Puttini P. Fibromyalgia and Sleep. Best Pract Res Clin Rheumatol. Baillière Tindall; 2011;25(2):227–39.
• 7. Méndez M, Blanchi AM, Villantieri O, Cerutti S. Time-varying analysis of the heart rate variability during REM and non REM sleep stages. Annual International Conference of the IEEE Engineering in Medicine and Biology - Proceedings. 2006;3576–9.
• 8. Staud R. Heart rate variability as a biomarker of fibromyalgia syndrome. Fut Rheumatol. 2008;3(5):475.
• 9. Puri BK, Lee GS. Clinical Assessment of Autonomic Function in Fibromyalgia by the Refined and Abbreviated Composite Autonomic Symptom Score (COMPASS 31): A Case-Controlled Study. Rev Recent Clin Trials. Bentham Science Publishers Ltd.; 2021;17(1):53–7.
• 10. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res. Psychiatry Res; 1989;28(2):193–213.
• 11. Agargün, M.Y., Kara, H., Anlar, O., et al. The validity and reliability of Pittsburg Sleep Index. Turkish Journal of Psychiatry. 1996;7:107-115.
• 12. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991;18(5):728–33.
• 13. Sarmer, S., Ergin, S., & Yavuzer, G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatology International.2000;20(1):9–12.
• 14. Sletten DM, Suarez GA, Low PA, Mandrekar J, Singer W. COMPASS 31: A Refined and Abbreviated Composite Autonomic Symptom Score. Mayo Clin Proc. Elsevier Ltd; 2012;87(12):1196.
• 15. Is, E. E., Ciftci Inceoglu, S., Tekin, S. C., Albayrak, B., Sonsoz, M. R., Kuran, B., & Singer, W. Validation and reliability of the Turkish version of the composite autonomic symptom score 31. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2024; 45(12):5779–5786.
• 16. Bhagya Lakxmi C, Henry RA, Surendran S, Pradeep M. Autonomic Dysfunction in Fibromyalgia Patients: Electrophysiological Evidence from a Cross-sectional Study in Kochi, India. Indian J Rheumatol. SAGE Publications Ltd; 2025;20(1):35–40.
• 17. Gezer HH, Erdem Gürsoy D, Acer Kasman S, Duruöz MT. Assessment of autonomic dysfunction with the COMPASS-31 and its relationship with disease activity and cardiovascular risks in patients with psoriatic arthritis. Rheumatol Int. Springer Science and Business Media Deutschland GmbH; 2022;42(9):1539–48.
• 18. Meling S, Tjora E, Eichele H, Ejskjaer N, Carlsen S, Njølstad PR, et al. The Composite Autonomic Symptom Score 31 Questionnaire: A Sensitive Test to Detect Risk for Autonomic Neuropathy. J Diabetes Res. John Wiley & Sons, Ltd; 2023;2023(1):4441115.
• 19. Solano C, Martinez A, Becerril L, Vargas A, Figueroa J, Navarro C, et al. Autonomic dysfunction in fibromyalgia assessed by the composite autonomic symptoms scale (COMPASS). Journal of Clinical Rheumatology. 2009;15(4):172–6.
• 20. Martínez-Martínez LA, Mora T, Vargas A, Fuentes-Iniestra M, Martínez-Lavín M. Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: A review of case-control studies. Journal of Clinical Rheumatology. Lippincott Williams and Wilkins; 2014;20(3):146–50.
• 21. Kulshreshtha P, Gupta R, Yadav RK, Bijlani RL, Deepak KK. A comprehensive study of autonomic dysfunction in the fibromyalgia patients. Clinical Autonomic Research. Springer; 2012;22(3):117–22.
• 22. Hazra S, Venkataraman S, Handa G, Yadav SL, Wadhwa S, Singh U, et al. A cross-sectional study on central sensitization and autonomic changes in fibromyalgia. Front Neurosci. Frontiers Media S.A.; 2020;14:543812.
• 23. Vincent A, McAllister SJ, Singer W, Toussaint LL, Sletten DM, Whipple MO, et al. A report of the autonomic symptom profile in patients with fibromyalgia. Journal of Clinical Rheumatology. 2014;20(2):106–8.
• 24. Singh R, Rai NK, Pathak A, Rai J, Pakhare A, Kashyap PV, et al. Impact of fibromyalgia severity on patients mood, sleep quality, and quality of life. J Neurosci Rural Pract. Scientific Scholar LLC; 2024;15(2):320.
• 25. Celepkolu T, Bucaktepe PGE, Yilmaz A, Pervane VD, Batmaz I, Sariyildiz MA. Assessment of quality of life, anxiety, depression, and sleep quality in women with fibromyalgia and their spouses. Eur Rev Med Pharmacol Sci. Verduci Editore s.r.l; 2021;25(13):4506–13.
• 26. Martinsen S, Flodin P, Berrebi J, Löfgren M, Bileviciute-Ljungar I, Ingvar M, et al. Fibromyalgia Patients Had Normal Distraction Related Pain Inhibition but Cognitive Impairment Reflected in Caudate Nucleus and Hippocampus during the Stroop Color Word Test. PLoS One. Public Library of Science; 2014;9(10):e108637.
• 27. Sarzi-Puttini P, Atzeni F, Diana A, Doria A, Furlan R. Increased neural sympathetic activation in fibromyalgia syndrome. Ann N Y Acad Sci. Blackwell Publishing Inc.; 2006;1069(1):109–17.
• 28. Afolalu EF, Ramlee F, Tang NKY. Effects of sleep changes on pain-related health outcomes in the general population: A systematic review of longitudinal studies with exploratory meta-analysis. Sleep Med Rev. W.B. Saunders; 2018;39:82–97.
• 29. Finan PH, Goodin BR, Smith MT. The Association of Sleep and Pain: An Update and a Path Forward. J Pain. Churchill Livingstone; 2013;14(12):1539–52.
• 30. Schestatsky P, Dall-Agnol L, Gheller L, Stefani LC, Sanches PRS, de Souza IC, et al. Pain–autonomic interaction after work-induced sleep restriction. Eur J Neurol. John Wiley & Sons, Ltd; 2013;20(4):638–46.
• 31. Kim H, Jung HR, Kim J Bin, Kim DJ. Autonomic Dysfunction in Sleep Disorders: From Neurobiological Basis to Potential Therapeutic Approaches. J Clin Neurol. Korean Neurological Association; 2022;18(2):140.
• 32. Rizzi M, Radovanovic D, Santus P, Airoldi A, Frassanito F, Vanni S, et al. Influence of autonomic nervous system dysfunction in the genesis of sleep disorders in fibromyalgia patients. Clin Exp Rheumatol. Clinical and Experimental Rheumatology S.A.S.; 2017;35:74–80.
• 33. Kang JH, Kim JK, Hong SH, Lee CH, Choi BY. Heart Rate Variability for Quantification of Autonomic Dysfunction in Fibromyalgia. Ann Rehabil Med. Korean Academy of Rehabilitation Medicine; 2016;40(2):301–9.