可用数据显示了时间类型之间的关联,昼夜节律,睡眠质量和纤维肌痛(FM)表现。然而,尚无研究探讨时间生物学变量与药物治疗有效性之间的联系.我们的目的是评估时间型,昼夜节律,FM的睡眠-觉醒周期和睡眠质量及其与5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRI)治疗反应的联系。60名FM患者:30名对SNRI(FMT[+])有反应,30名对SNRI无反应(FMT[-])和30名健康对照参加。受试者由医生和问卷工具进行评估:晨显综合量表,神经精神病学评估的生物节律访谈,睡眠-觉醒模式评估问卷,匹兹堡睡眠质量指数和纤维肌痛影响问卷。使用ANOVA分析和简单逻辑回归来检查时间变量与对SNRI的反应之间的关系。FMT[-]vs.FMT[+]呈现较低的上午影响(11.50[95CI9.96-13.04]与14.00[95CI12.42-15.57];p=0.04),随时唤醒能力(2.27[95CI1.4-3.13]vs.4.03[95CI2.99-5.08];p=0.013)总体较差(11.40[95CI9.92-12.88]与7.97[95CI6.75-9.19];p=0.002)和主观(1.70[95CI1.30-2.01]与1.17[95CI0.94-1.39];p=0.008)睡眠质量,更高的昼夜节律中断(55.47[95CI52.32-58.62]vs.44.97[95CI41.31-48.62];p<0.001),睡眠障碍(1.63[95CI1.38-1.68]vs.1.30[95CI1.1-1.5];p=0.04),安眠药使用(1.80[95CI1.27-2.32]vs.0.70[95CI0.28-1.12];p=0.003)。晨显水平(AIC=82.91,OR=0.93,p=0.05),晨起影响(AIC=81.901,OR=0.86,p=0.03)昼夜节律异常(AIC=69.566,OR=1.14,p<0.001),随时唤醒能力(AIC=80.307,OR=0.76,p=0.015),总体睡眠质量(AIC=74.665,OR=1.31,p=0.002)主观睡眠质量(AIC=79.353,OR=2.832,p=0.01)和干扰(AIC=82.669,OR=2.54,p=0.043),睡眠药物使用(AIC=77.017,OR=1.9,p=0.003)和日间功能障碍(AIC=82.908,OR=1.971,p=0.049)是SNRI无应答的预测因子.时间生物学变量在FMT[+]和FMT[-]之间变化,并且是对SNRI无反应的预测因子。
Available data shows associations between chronotype, circadian rhythms, sleep quality and fibromyalgia (FM) presentation. However, no studies have explored links between the chronobiological variables and effectiveness of pharmacotherapy. We aimed to assess the chronotypes, circadian rhythms, sleep-wake cycle and sleep quality in FM and their links to treatment response to serotonin and noradrenalin reuptake inhibitors (SNRI). 60 FM patients: 30 responsive to SNRI (FM T[+]), 30 non-responsive to SNRI (FM T[-]) and 30 healthy controls participated. Subjects were assessed by physician and with questionnaire tools: Composite Scale of Morningness, Biological Rhythms Interview of Assessment in Neuropsychiatry, Sleep-Wake Pattern Assessment Questionnaire, Pittsburgh Sleep Quality Index and Fibromyalgia Impact Questionnaire. ANOVA analysis and simple logistic regressions were used to examine the relationships between chronological variables and response to SNRI. FM T[-] vs. FM T[+] presented lower morning affect (11.50[95%CI 9.96-13.04] vs. 14.00[95%CI 12.42-15.57];p=0.04), anytime wakeability (2.27[95%CI 1.4-3.13] vs. 4.03[95%CI 2.99-5.08];p=0.013) worse overall (11.40[95%CI 9.92-12.88] vs. 7.97[95%CI 6.75-9.19];p=0.002) and subjective (1.70[95%CI 1.30-2.01] vs. 1.17[95%CI 0.94-1.39];p=0.008) sleep quality, higher circadian rhythm disruptions (55.47[95%CI 52.32-58.62] vs. 44.97[95%CI 41.31-48.62];p<0.001), sleep disturbances (1.63[95%CI 1.38-1.68] vs. 1.30[95%CI 1.1-1.5];p=0.04), sleeping-medication use (1.80[95%CI 1.27-2.32] vs. 0.70[95%CI 0.28-1.12];p=0.003). Levels of morningness (AIC=82.91,OR=0.93,p=0.05), morning affect (AIC=81.901,OR=0.86,p=0.03) diurnal dysrhythmia (AIC=69.566,OR=1.14,p<0.001), anytime wakeability (AIC=80.307,OR=0.76,p=0.015), overall sleep quality (AIC=74.665, OR=1.31,p=0.002) subjective sleep quality (AIC=79.353, OR=2.832,p=0.01) and disturbances (AIC=82.669,OR=2.54,p=0.043), sleep medication use (AIC=77.017, OR=1.9,p=0.003) and daytime disfunction (AIC=82.908, OR=1.971,p=0.049) were predictors of non-response to SNRI. Chronobiological variables vary between FM T[+] and FM T[-] and are predictors of non-response to SNRI.