Sleep Disturbance and Fibromyalgia

Sleep disturbances in fibromyalgia syndrome: Relationship to pain and depression.

Arthritis Rheum. 2008 Jun 24;59(7):961_967. [Epub ahead of print]

Bigatti SM, Hernandez AM, Cronan TA, Rand KL.

Indiana University~Purdue University Indianapolis, Indiana.

PMID: 18576297

 

OBJECTIVE: This study is an examination of sleep, pain, depression, and physical functioning at baseline and 1_year followup among patients with fibromyalgia syndrome (FMS). Although it is clear that these symptoms are prevalent among FMS patients and that they are related, the direction of the relationship is unclear. We sought to identify and report sleep problems in this population and to examine their relationship to pain, depression, and physical functioning.

METHODS: Patients diagnosed with fibromyalgia were recruited from a Southern California health maintenance organization and evaluated according to American College of Rheumatology criteria in the research laboratory. Six hundred patients completed the baseline assessment and 492 completed the 1_year assessment. Measures included the Center for Epidemiologic Studies Depression Scale, the McGill Pain Questionnaire, the Pittsburgh Sleep Quality Index, and the Fibromyalgia Impact Questionnaire.

RESULTS: The majority of the sample (96% at baseline and 94.7% at 1 year) scored within the range of problem sleepers. Path analyses examined the impact of baseline values on 1_year values for each of the 4 variables. No variable of interest predicted sleep, sleep predicted pain (beta = 0.13), pain predicted physical functioning (beta = _0.13), and physical functioning predicted depression (beta = _0.10).

CONCLUSION: These findings highlight the high prevalence of sleep problems in this population and suggest that they play a critical role in exacerbating FMS symptoms. Furthermore, they support limited existing findings that sleep predicts subsequent pain in this population, but also extend the literature, suggesting that sleep may be related to depression through pain and physical functioning.

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I had constant pain until I got my Sleep Number bed. By the end of the first week, I considered my fibromyalgia cured -- it no longer hurt just to exist. The fibro test points do still hurt when someone presses on them, so technically I still have fibro, but being able to sleep more than 2 hours before waking up in pain has had a big effect on my ability to function the next day. (And the time available to function, because I'm not spending a huge chunk of the day in a hot bath trying to ease the pain enough to be able to concentrate.)

Just like with CFS, fixing the quality of sleep is the first step in fixing fibromyalgia. A lot can be achieved by getting enough sleep to let the body start healing itself.