Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T18:37:06.938Z Has data issue: false hasContentIssue false

The Significance, Assessment, and Management of Nonrestorative Sleep in Fibromyalgia Syndrome

Published online by Cambridge University Press:  07 November 2014

Harvey Moldofsky*
Affiliation:
Dr. Moldofsky is professor emeritus of the Faculty of Medicine at the, University of Torontoand president of the Sleep Disorders Clinic of the Centre for Sleep and Chronobiology in Toronto, Ontario, Canada.
*
Toronto Psychiatric Research Foundation, 951 Wilson Ave, Unit 15, Toronto ON, CanadaM3K 2A7; E-mail: h.moldofsky@utoronto.ca

Abstract

People with fibromyalgia syndrome (FMS) experi-ence unrefreshing sleep, aches, hypersensitivity, and cognitive and emotional difficulties. Although no specific causative factor or biological agent is known to account for all of the features of FMS and these related diagnoses, the generalized hypersensitivity of the body is considered to be affected by disturbances in cen-tral nervous system (CNS) functions. Such CNS dis-turbances are intrinsic to the sleeping-waking brain, where the common symptom elements in all these illnesses are poor quality of sleep, nonspecific pain, fatigue, and psychological distress in the absence of known disease pathology.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Aaron, LA, Burke, MM, Buchwald, D. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med. 2000;24;160:221227.CrossRefGoogle Scholar
2.Yunus, MB, Ahles, TA, Aldag, JC, et al.The relationship of the clinical features with psy-chological status in primary fibromyalgia. Arth Rheumatism. 1991;34:1521.Google Scholar
3.Torpy, DJ, Papanicolaou, DA, Lotsikas, , et al.Responses of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis to interleukin-6: A pilot study in fibromyalgia. Arth Rheumatism. 2001;43:872890.3.0.CO;2-T>CrossRefGoogle Scholar
4.Martinez-Lavin, M, Hermosillo, AG, Rosas, M, et al.Circadian studies of autonomic nervous balance in patients with fibromyalgia: a heart rate variability analysis. Arth Rheum. 1998;41:19661971.Google Scholar
5.Unger, ER, Nisenbaum, R, Moldofsky, H. Sleep assessment in a population-based study of chronic fatigue syndrome. BMC Neurol. 2004;4(1):6.Google Scholar
6.Moldofsky, H, Scarisbrick, P, England, R, et al.Musculoskeletal symptoms and NonREM sleep disturbance in patients with fibrositis syndrome and healthy subjects. Psychosom Med. 1975;34:341351.Google Scholar
7.Côté, KA, Moldofsky, H. Sleep, daytime symptoms, and cognitive performance in patients with fibromyalgia. J Rheumatol. 1997;24:20142023.Google Scholar
8.Hakki Onen, S, Alloui, A, Jourdan, D, et al.Effects of rapid eye movement (REM) sleep deprivation on pain sensitivity in the rat. Brain Res. 2001;900:261267.Google Scholar
9.Moldofsky, H. Rheumatic pain modulation syndrome: the inter-relationships between sleep, central nervous system serotonin, and pain. In: Advances in Neurology. Vol 33. Critchley, M, AP, Freedman, Sicuteri, F, Gorini, S, eds. New York, NY: Raven Press; 1982:5157.Google Scholar
10.Andersen, ML, Nascimento, DL, Machado, RB, et al.Sleep disturbance induced by Substance P in mice. Behav Brain Res. 2006;167:212218.CrossRefGoogle ScholarPubMed
11.Drewes, AM, Nielson, KD, Arendt-Nielson, L, et al.The effect of cutaneous and deep pain on the electroencephalogram during sleep: an experimental study. Sleep. 1997;20:632640.CrossRefGoogle ScholarPubMed
12.Lavigne, G, Brousseau, M, Kato, T, et al.Experimental pain perception remains equally active over all sleep stages. Pain. 2004;110:646655.Google Scholar
13.Moldofsky, H, Scarisbrick, P. Induction of neurasthenic musculoskeletal pain syndrome by selective sleep stage deprivation. Psychosom Med. 1976;38:3544.CrossRefGoogle ScholarPubMed
14.Moldofsky, H, MacFarlane, J. Fibromyalgia and chronic fatigue syndrome. In: Principles and Practice of Sleep Medicine. 4th ed. MH, Kryger, ed. Philadelphia, PA: Thomas Roth and William Dement. Elsevier Saunders Ltd; 2005:12251236.Google Scholar
15.Kundermann, B, Spernal, J, Huber, MT, et al.Sleep deprivation affects thermal pain thresholds but not somatosensory thresholds in healthy volunteers. Psychosom Med. 2004;66:932937.Google Scholar
16.Roehrs, T, Hyde, M, Blaisdell, B, et al.Sleep loss and REM sleep loss are hyperalgesic. Sleep. 2006;29(2):145151.Google Scholar
17.Smith, MT, Edwards, RR, McCann, UD, et al.The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep. 2007;30:494505.Google Scholar
18.Roizenblatt, S, Moldofsky, H, Benedito, AA, et al.Alpha sleep characteristics in fibromyalgia. Arth Rheum. 2001;44:222230.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
19.Rizzi, M, Sarzi-Puttini, P, Atzeni, F, et al.Cyclic alternating pattern: a new marker of sleep alteration in patients with fibromyalgia? J Rheumatol. 2004;31:11931199.Google Scholar
20.Gurbaxani, BM, Jones, JF, Goertzel, BN, et al.Linear data mining the Wichita clinical matrix suggests sleep and allostatic load involvement in chronic fatigue syndrome. Pharmacogenomics. 2006;7(3):455465.CrossRefGoogle ScholarPubMed
21.Crofford, LJ, Rowbotham, MC, Mease, PJ, et al.Pregabalin for the treatment of fibro-myalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arth Rheum. 2005;52:12641273.Google Scholar
22.Arnold, LM. Duloxetine and other antidepressants in the treatment of patients with fibromyalgia. Pain Med. 2007;8(suppl 2):S63S74.Google Scholar
23.Holman, AJ, Myers, RR. A randomized, double blind, placebo controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arth Rheum. 2005;52:24952505.Google Scholar
24.Scharf, MB, Baumann, M, Berkowitz, DV. The effect of sodium oxybate on clinical symptoms and sleep patterns in patients with fibromyalgia. J Rheumatol. 2003;30:10701074.Google Scholar