Clinical Features, Socio-cultural Characteristics, Sleep Patterns, and Depression in Fibromyalgia Patients from India: A Cross-Sectional Study

Abstract

Fibromyalgia (FM) is a complex and chronic disease with significant regional variation. There is a lack of studies on Fibromyalgia (FM) in Indian population. The aim of this study is to investigate the clinical features of FM patients in India, including the prevalence and distribution of comorbidities, sleep patterns, and depression. Cross-sectional analysis of patients attending outpatient rheumatology clinic from 2019-2020 fell in the ACR2016 criteria for FM. Of the 121 patients enrolled in the study, the majority (93.4%) were female, with a female-to-male ratio of 14:1. The mean age of the patients was 45 ±11 years. The socio-cultural profile of the patients revealed that the majority were married (88%) and homemakers (68.8%), lived in nuclear families (56%) and were middle to upper middle class (68.6%). Contrary to the existing literature, a higher prevalence of FM has been observed in people with a higher educational status. Common clinical symptoms were extensive body aches (100%), fatigue (88%), difficulty concentrating (69.4%), irritability and gastrointestinal complaints (58.5%). We observed a high prevalence of primary headache (76%), mainly migraine (42%) and obsessive-compulsive (OCB) (71%). Sleep disturbances and depression were found in the significant number of patients with FM. The patients reported various sleep problems, such as snoring, waking up at night, daytime sleepiness, and taking daytime naps. Most of the patients had mild (50.8%) to moderate (29%) depression, while a smaller proportion experienced severe (6.6%) symptoms. Most of the patients had low serum vitamin D (91%). The presence of moderate to severe depression was associated with the severity of FM. The demographic profile of Indian patients was similar to that reported in the literature but had varied socio-cultural profiles needing further community-based studies. The high prevalence of psychological comorbidities and sleep disturbances highlights their importance in managing FM patients.