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

Introduction: Fibromyalgia is a complex and chronic disease with significant regional variation and lack of studies from Indian population.

Objective: Aim to investigate the clinical features of fibromyalgia patients in India, including the prevalence and distribution of comorbidities, sleep patterns, and depression.

Method: Cross-sectional analysis of consecutive patients attending outpatient Rheumatology clinic from 2019-2020 satisfying ACR2016 criteria for fibromyalgia.

Results:

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 fibromyalgia 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 compulsive behaviour (OCB) (71%). Sleep disturbances and depression were found to be significant factors associated with fibromyalgia. 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 vitamin D(91%).

Conclusion: 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.