Presentation (CTI)

OBJECTIVES: Fibromyalgia, a chronic pain disorder affects 5-10 million adults in the US, mostly women. Recent real-world data on the burden of insomnia in patients with Fibromyalgia is limited. To compare long-term clinical and economic outcomes of adult patients with and without insomnia following Fibromyalgia diagnosis.
METHODS: This retrospective cohort study utilizing data from Premier Healthcare Database was conducted among adult patients visiting US hospital-based clinics with a primary diagnosis of Fibromyalgia between January 1, 2018 and June 30, 2021. Two cohorts of patients with and without insomnia following Fibromyalgia were identified. Propensity score matched analysis was conducted to compare outcomes between the two cohorts within one and three years of index visit.
RESULTS: Among 7,422 patients with Fibromyalgia, the prevalence of insomnia was 10% (median age 52 years, 94.6% female, 14.5% Black). After matching for confounders, 749 patients had insomnia and 2,211 no-insomnia. A higher proportion of patients with insomnia were on sedatives, muscle relaxants, antidepressants and anxiolytics compared to the no-insomnia cohort (range:17% to 53.7% vs. 8.4% to 41.3%, p<0.001). Insomnia (vs. no-insomnia), within one year of index discharge had higher median number of revisits (7 vs. 5); rates of depression (34.3% vs. 15.6%); drug use (10.3% vs. 6.7%); and median revisit cost ($3,383 vs. $1,901, p<0.001). By three years, Insomnia patients were at higher odds for outpatient service use (OR=1.8).
CONCLUSIONS: This study demonstrates that in Fibromyalgia patients, insomnia is associated with increased long-term mental morbidity, cost and higher use of ambulatory services, compared to no-insomnia.