P092 Missed opportunities: obstructive sleep apnoea is under-screened in fibromyalgia patients

Abstract Background/Aims Fibromyalgia (FMS) is a prevalent syndrome characterised by widespread pain, fatigue, and disturbed sleep. Obstructive sleep apnoea (OSA) can mimic and worsen FMS symptoms but is often unrecognised in rheumatology clinics. Validated tools such as the Berlin Sleep Questionnaire (BSQ), STOP-BANG, and Epworth Sleepiness Scale (ESS) may facilitate risk stratification and referral. Objective: To evaluate current clinical screening for OSA in FMS patients and identify gaps in routine practice Methods A one-month multicentre retrospective audit was conducted across three South Wales hospitals. Adult patients meeting ACR 1990/2010 FMS criteria were included; those with known OSA were excluded. Patient notes were reviewed for demographics, comorbidities, documentation of sleep disturbances, use of OSA screening tools, and referrals for sleep studies. Subsequently, patients completed the BSQ, STOP-BANG, and ESS questionnaires to assess OSA risk. Results 96 FMS patients were identified with a mean age 50.3 years, 95 % were female and average BMI 32.7. Sleep disturbances were documented in 43.8% of cases; however, none had been asked about snoring, patterns of sleeplessness or screened for OSA using validated questionnaires. A subsequent questionnaire revealed that 94% of patients actually experienced sleep issues and of those 59% reported snoring; this highlights a significant gap between patient symptoms and clinical documentation. Applying validated tools found that 31% of patients were high-risk by BSQ, 28% by STOP-BANG (4), and 41% scored ≥11 on the ESS. There were strong associations between all the 3 screening questionnaires (p 0.001); however, there was a closer association between the STOP-BANG and BSQ (Cramér’s V = 0.860) which both focus on physiological risk factors whereas the ESS focuses on subjective symptoms. Overall, between 31-68% met criteria for sleep study referral depending on the screening tool used. Snoring was a strong predictor of high-risk scores across all tools: ESS (RR 5.0, p = 0.002), BSQ (RR 5.3, p 0.001), and STOP-BANG (RR 3.8, p 0.001). Conclusion OSA is a frequent and critically under-recognised comorbidity in FMS, and the complete absence of screening in routine practice represents a major care gap. Incorporating a question about snoring followed by screening questionnaire for OSA in patients with FMS and sleep disturbances could significantly improve identification and management of OSA in this cohort. Early detection has the potential to reduce fatigue and pain, improve sleep quality, and enhance overall quality of life. Multicentre prospective studies are warranted to assess the impact of systematic screening on clinical outcomes. Disclosure P. Partha Sarathy: None.