Open Access Highly Accessed Open Badges Research article

The association of sleep difficulties with health-related quality of life among patients with fibromyalgia

Jan-Samuel Wagner1, Marco D DiBonaventura1*, Arthi B Chandran2 and Joseph C Cappelleri3

Author affiliations

1 Health Outcomes Practice, Kantar Health, 11 Madison Avenue, 12th Floor, New York, NY, 10010, USA

2 Pfizer Inc., 235-09-02, 235 East 42nd Street, New York, NY, 10017, USA

3 Pfizer Inc., 445 Eastern Point Road, MS 8260-2502, Groton, CT 06340, USA

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Citation and License

BMC Musculoskeletal Disorders 2012, 13:199  doi:10.1186/1471-2474-13-199

Published: 17 October 2012



Difficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM.


The current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables.


Of the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population.


Among the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted.

Fibromyalgia; Sleep; Insomnia; Health-related quality of life; Pain