title: Influence of weather on daily symptoms of pain and fatigue in female patients with fibromyalgia: a multilevel regression analysis.
abstract: OBJECTIVE
  Although patients with fibromyalgia often report that specific weather conditions aggravate their symptoms, empirical studies have not conclusively demonstrated such a relationship. Our aim was to examine the association between weather conditions and daily symptoms of pain and fatigue in fibromyalgia, and to identify patient characteristics explaining individual differences in weather sensitivity.
  
  
  METHODS
  Female patients with fibromyalgia (n = 333, mean age 47.0 years, mean time since diagnosis 3.5 years) completed questions on pain and fatigue on 28 consecutive days. Daily weather conditions, including air temperature, sunshine duration, precipitation, atmospheric pressure, and relative humidity, were obtained from the Royal Netherlands Meteorological Institute. Multilevel regression analysis was applied.
  
  
  RESULTS
  In 5 (10%) of 50 analyses, weather variables showed a significant but small effect on either pain or fatigue. In 10 analyses (20%), significant, small differences between patients were observed in the random effects of the weather variables, suggesting that symptoms of patients were, to a small extent, differentially affected by some weather conditions, for example, high pain with either low or high atmospheric pressure. These individual differences were explained neither by demographic, functional, or mental patient characteristics, nor by season or weather variation during the assessment period.
  
  
  CONCLUSIONS
  There is more evidence against than in support of a uniform influence of weather on daily pain and fatigue in female patients with fibromyalgia. Although individuals appear to be differentially sensitive to certain weather conditions, there is no indication that specific patient characteristics play a role in weather sensitivity.
authors.affiliation: Utrecht University, 3508 TC Utrecht, The Netherlands.
authors.forename: Ercolie R
authors.initials: ER
authors.lastname: Bossema
authors.forename: Henriët
authors.initials: H
authors.lastname: van Middendorp
authors.forename: Johannes W G
authors.initials: JW
authors.lastname: Jacobs
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001274:Atmospheric Pressure; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006813:Humidity; D008137:Longitudinal Studies; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D010147:Pain Measurement; D012307:Risk Factors; D012737:Sex Factors; D013472:Sunlight; D011795:Surveys and Questionnaires; D013696:Temperature; D014887:Weather; D055815:Young Adult