Sleep-Wake Disturbances in Fibromyalgia

Abstract

Fibromyalgia characterized unrefreshing sleep, sleep physiological disturbances, depressed mood, and cognitive difficulties in addition to widespread pain, persisting for at least 3 months, and a minimum of 11 of 18 tender points, tenderness, and other somatic symptoms. Among polysomnographic abnormalities, the most common finding is the intrusion of alpha rhythm into NREM sleep (alpha-delta sleep). Patients with fibromyalgia also exhibit prolonged sleep onset latencies, an increased number of arousal, and increases in stage 1 sleep. However, alpha-delta sleep is not specific or pathognomonic for the diagnosis of fibromyalgia and may represent an epiphenomenon of an undefined central nervous system disturbance. A strong relationship between sleep disturbance and pain perception is clear in fibromyalgia. The interactions among immune system, pain, and sleep disturbance and therapeutic implications are discussed in this article.