Sleep and Fibromyalgia



Introduction[edit | edit source]

Fibromyalgia is a musculoskeletal condition characterized by widespread chronic muscle pain and fatigue, sleep disturbances, cognitive disorders, and mood disturbances. According to ongoing researches, fibromyalgia is a pain control illness that is usually described as a type of central sensitization syndrome.[1]

Symptoms[edit | edit source]

Musculoskeletal pain[edit | edit source]

Fibromyalgia patient, primary complaint of bilateral, all-over musculoskeletal discomfort that affects both the upper and lower extremities. In the beginning, the pain is localised, usually in the shoulders and neck. Although joint pain is also often reported, muscle pain is the most typical description of the condition.[2]

Cognitive disturbances[edit | edit source]

Patients with FMS have difficulty doing tasks that require attention and rapid changes.

Fatigue[edit | edit source]

The most important symptom of FMS is fatigue. This increases, especially when they wake up from sleep. [3]

Pathophysiology[edit | edit source]

Fibromyalgia is a pain regulation disorder, This hypervigilance of pain cause numerous psychological symptoms, that includes:

  • increased level of anxiety
  • higher level of depression
  • inability to use coping methods

Diagnosis[edit | edit source]

The widespread pain index (WPI) is greater than or equal to 7, the symptom severity (SS) scale score is greater than or equal to 5, the WPI equals 3 to 6, and the SS scale score is greater than or equal to 9. [4]

Criteria for diagnosis[edit | edit source]

The criteria for diagnosis of fibromyalgia is generalised chronic pain covering 19 regions, with the presence of additional measures of sleep, fatigue, cognitive, mood symptoms and other sources of pain.

Sleep and fibromyalgia[edit | edit source]

A common symptom of fibromyalgia is it effect on sleep. Sleep problems are common and may increase their symptoms contributing to insomnia and poor sleep. Fibromyalgia and sleep have a two-way relationship, in which one affects the other. Poor sleep can intensify the feelings of pain and tenderness. furthermore, lowering the persons pain threshold. [5]

Physiology[edit | edit source]

According to researches, people with fibromyalgia has lower pain threshold as compared to people without this condition. The two common symptoms include non-restorative sleep and daytime fatigue. People with this condition experience wakefulness during non rapid eye movement (NREM) during the stages of sleep cycle.

Evidence[edit | edit source]

  1. According to a research done in California, to examine sleep, pain, depression in people with fibromyalgia. The study concluded that there was high prevalence of sleep problems and suggest that they play a crucial role in exacerbating FMS symptoms. Sleep quality was measured using Pittsburgh sleep quality index (PSQI) and pain using McGill pain questionnaire. [6]
  2. Affleck et al, investigated pain and sleep problems for over a period of 30 day in patients with FMS symptoms, using handheld devices to record sleep quality. Their findings suggested that sleep difficulties the night before predicted increased pain during the day. [7].
  3. Poor sleep quality and pain can have a significant impact on the overall quality of life of FM patients. [8]
  4. Epidemiological studies indicate that lower sleep quality is a risk factor for fibromyalgia; poor sleep is strongly and dose-dependently associated with symptom severity in the fibromyalgia population. [9]

References[edit | edit source]

  1. ↑ Pomares FB, Funck T, Feier NA, Roy S, Alexandre Daigle-Martel, Ceko M, et al. Histological Underpinnings of Grey Matter Changes in Fibromyalgia Investigated Using Multimodal Brain Imaging. The Journal of Neuroscience [Internet]. 2016 Dec 16 [cited 2024 Mar 26];37(5):1090–101. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6596849/ ‌
  2. ↑ Björkegren K, Wallander MA, Johansson S, Svärdsudd K. General symptom reporting in female fibromyalgia patients and referents: a population-based case-referent study. BMC Public Health [Internet]. 2009 Oct 31 [cited 2024 Mar 26];9(1). Available from: https://pubmed.ncbi.nlm.nih.gov/19878599/ ‌
  3. ↑ Aggarwal VR, McBeth J, Zakrzewska JM, Lunt M, Macfarlane GJ. The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors? International Journal of Epidemiology [Internet]. 2005 Nov 22 [cited 2024 Mar 26];35(2):468–76. Available from: https://pubmed.ncbi.nlm.nih.gov/16303810/ ‌
  4. ↑ Bhargava J, Hurley JA. Fibromyalgia [Internet]. Nih.gov. StatPearls Publishing; 2023 [cited 2024 Mar 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK540974/#:~:text=A%20patient%20fulfills%20the%20diagnostic,than%20or%20equal%20to%209. ‌
  5. ↑ Fibromyalgia and Sleep: Sleep Disturbances & Coping [Internet]. Sleep Foundation. 2020 [cited 2024 Mar 26]. Available from: https://www.sleepfoundation.org/physical-health/fibromyalgia-and-sleep#:~:text=Sleep%20and%20fibromyalgia%20share%20a,lower%20a%20person's%20pain%20threshold. ‌
  6. ↑ Bigatti SM, Ann Marie Hernandez, Cronan TA, Rand KL. Sleep disturbances in fibromyalgia syndrome: Relationship to pain and depression. Arthritis Care & Research [Internet]. 2008 Jun 24 [cited 2024 Mar 26];59(7):961–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691959/ ‌
  7. ↑ Affleck G, Urrows S, Tennen H, Higgins P, Abeles M. Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia. PAIN [Internet]. 1996 Dec 1 [cited 2024 Mar 26];68(2):363–8. Available from: https://pubmed.ncbi.nlm.nih.gov/9121825/ ‌
  8. ↑ Yu Lin Wu, Ling Yin Chang, Hsin Chien Lee, Su Chen Fang, Pei Shan Tsai. Sleep disturbances in fibromyalgia: A meta-analysis of case-control studies. Journal of Psychosomatic Research [Internet]. 2017 May 1 [cited 2024 Mar 26];96:89–97. Available from: https://pubmed.ncbi.nlm.nih.gov/28545798/ ‌
  9. ↑ Écija C, Luque-Reca O, Suso-Ribera C, Catala P, Peñacoba C. Associations of Cognitive Fusion and Pain Catastrophizing with Fibromyalgia Impact through Fatigue, Pain Severity, and Depression: An Exploratory Study Using Structural Equation Modeling. Journal of Clinical Medicine [Internet]. 2020 Jun 6 [cited 2024 Mar 26];9(6):1763–3. Available from: https://www.mdpi.com/2077-0383/9/6/1763 ‌
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