Fibromyalgia is a pain amplification syndrome produced by persistent afferent sensory stimulation and manifested as a central sensitization syndrome. Multiple studies including neuroimaging studies have consistently shown that fibromyalgia syndrome (FM) pain emanates from changes in the brain and spinal cord using the same mechanism that makes sunburnt skin sensitive to light touch. The role of sleep in the etiopathogenesis of fibromyalgia is underscored by the fact that up to 90% of FM patients have non-restorative sleep. The sleep disturbance should be investigated to ascertain whether periodic limb movement syndrome, sleep apnea, bruxism or acid reflux disease is present. FM is modified by hormonal, cytokine, neurotransmitter, and autonomic influences. The overwhelming majority with FM have sleep disorders, with the alpha-delta abnormality being the principal pathology. Managing sleep pathology in FM appropriately ameliorates the symptoms and signs of the syndrome more than almost any other intervention.

Fibromyalgia syndrome (FMS) is characterized by complaints of generalized musculoskeletal pain and the finding on physical examination of tenderness in characteristic regions. Approximately one-third of patients date the onset of their FMS to a traumatic experience such as a motor vehicle accident or to an event such as an illness. The prevalence of FMS has been studied in a number of settings including outpatients, private and hospital clinic populations, as well as community settings. The economic repercussions of FMS are enormous. One estimate suggests that long-term disability payments for FMS in Canada may cost the insurance industry as much as $200 million per year. An alteration in sleep physiology was hypothesized to be the underlying cause of FMS. There is a variable spectrum of complaints and findings in patients with FMS. Mild FMS is found in the community in patients who do not feel the need to seek medical attention.