Alpha sleep characteristics in fibromyalgia

Roizenblatt, Suely; Moldofsky, Harvey; Benedito‐Silva, Ana Amélia; Tufik, Sérgio

doi:10.1002/1529-0131(200101)44:1<222::aid-anr29>3.0.co;2-k

Cited by 230 publications

(119 citation statements)

References 62 publications

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“…Various alterations in non-rapid eye movement (non-REM) sleep physiology have been identified. These include the presence of a prominent alpha (7 to 12 Hz) electroencephalographic (EEG) non-REM sleep anomaly, commonly called alpha intrusions or alpha EEG sleep disorder, which has been observed in most studies 8,9,10,11,12,13 . This anomaly acts as an indicator of a vigilant state during non-REM sleep, with resulting daytime symptoms of unrefreshing or nonrestorative sleep 14 .…”

mentioning

confidence: 99%

Effects of Sodium Oxybate on Sleep Physiology and Sleep/Wake-related Symptoms in Patients with Fibromyalgia Syndrome: A Double-blind, Randomized, Placebo-controlled Study

Moldofsky¹,

Inhaber²,

Guinta³

et al. 2010

J Rheumatol

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227

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Objective.To determine the effects of sodium oxybate (SXB) on sleep physiology and sleep/wake-related symptoms in patients with fibromyalgia syndrome (FM).Methods.Of 304 patients with FM (American College of Rheumatology tender point criteria) in the screened study population, 209 underwent polysomnography, 195 were randomized, and 151 completed this 8-week, double-blind, placebo-controlled study of SXB 4.5 g and 6 g/night. We evaluated changes in objective sleep measures and subjective symptoms, including daytime sleepiness [Epworth Sleepiness Scale (ESS)], fatigue visual analog scale (FVAS), sleep [Jenkins Scale for Sleep (JSS)], and daytime functioning [Functional Outcome of Sleep Questionnaire (FOSQ), SF-36 Vitality domain, and Fibromyalgia Impact Questionnaire (FIQ) general and morning tiredness].Results.Pretreatment screening revealed an elevated incidence of maximum alpha EEG-intrusion > 24 min/hour of sleep (66%), periodic limb movements of sleep (20.1% ≥ 5/hour), and moderate to severe obstructive sleep apnea disorder (15.3% apnea-hypopnea index ≥ 15/hour). Compared with placebo, both doses of SXB achieved statistically significant improvements in ESS, morning FVAS, JSS, FOSQ, SF-36 Vitality, and FIQ general and morning tiredness; both doses also demonstrated decreased rapid eye movement (REM) sleep (all p ≤ 0.040). SXB 6 g/night improved afternoon, evening and overall FVAS, reduced wakefulness after sleep onset, and increased Stage 2, slow-wave, and total non-REM sleep (all p ≤ 0.032) versus placebo. Moderate correlations (≥ 0.40) were noted between changes in subjective sleep and pain measures. Adverse events occurring significantly more frequently with SXB than placebo were nausea, pain in extremity, nervous system disorders, dizziness, restlessness, and renal/urinary disorders (including urinary incontinence).Conclusion.This large cohort of patients with FM demonstrated that SXB treatment improved EEG sleep physiology and sleep-related FM symptoms.

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mentioning

confidence: 99%

Effects of Sodium Oxybate on Sleep Physiology and Sleep/Wake-related Symptoms in Patients with Fibromyalgia Syndrome: A Double-blind, Randomized, Placebo-controlled Study

Moldofsky¹,

Inhaber²,

Guinta³

et al. 2010

J Rheumatol

Self Cite

227

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“…It is characterized not only by a widespread pain observed due to the presence of multiple tender points but also by depressive behavior, fatigue and sleep disturbances without any structural or inlammatory cause [125,126]. Studies have consistently demonstrated a female predominance of this disease [127] with a major frequency in pre-and postmenopause condition supporting that an abrupt decline or a reduced time of exposure to ovarian hormones may contribute to FM [128].…”

Section: Comorbidity In Menopause and Alternative Medicinementioning

confidence: 99%

Use of Phytoestrogens for the Treatment of Psychiatric Symptoms Associated with Menopause Transition

Estrada‐Camarena¹,

López‐Rubalcava²,

Sustaita³

et al. 2017

A Multidisciplinary Look at Menopause

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Menopause transition is recognized as a vulnerable period in women life to develop or aggravate symptoms of psychiatric disorders. Several treatments including antidepressants and hormonal restitution with estrogens have been suggested to ameliorate the symptoms. Also, in this period of life is frequent the use of other drugs to treat is also frequent the use of other drugs to treat comorbid pathologies that might even increase the risk of drug-drug interactions. Literature reports that some phytochemicals with estrogenic activity have beneicial efects during menopausal transition without collateral events. This chapter shows evidence about the use of phytoestrogens as an alternative therapy for the treatment of some psychiatric symptoms associated with the menopausal transition. Data derived from preclinical research related to the use of classical phytoestrogens (isolavones), considering the beneicial efects, as well as adverse events, are discussed. Also, the use of polyphenols and organosulfurate compounds as an alternative for the treatment of anxiety-and depressive-like behavior as well as ibromyalgia is included. A narrative review was conducted using bibliography reporting the use of isolavones (genistein, daidzein, equol), coumestans or lignans for the reduction of depressive-like or anxiety-like behavior. Furthermore, it is described if the use of this compounds impact in other signs of menopause, i.e. vasomotor and osteoporosis. In addition, due to the high frequency of comorbid pathologies as diabetes mellitus, dyslipidemia or metabolic syndrome with psychiatric disorders, the use of these phytochemicals is discussed.

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“…28 Studies have also demonstrated that these patients experience increased NREM sleep alpha-rhythm intrusions during slow wave sleep as assessed via electroencephalography (EEG). 29,30 These intrusive patterns of increased alpha-EEG activity have also been associated with more frequent microarousals from sleep, which have the potential to result in increased movement relative to poor sleepers without chronic pain. These findings, in conjunction with objective investigations on sleep in chronic pain patients, indicate that patients with chronic pain may generally experience greater sleep fragmentation, movement, and time spent awake at night.…”

Section: Introductionmentioning

confidence: 99%

Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments

Mundt

Crew

Krietsch

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: In insomnia, actigraphy tends to underestimate wake time compared to diaries and PSG. When chronic pain co-occurs with insomnia, sleep may be more fragmented, including more movement and arousals. However, individuals may not be consciously aware of these arousals. We examined the baseline concordance of diaries, actigraphy, and PSG as well as the ability of each assessment method to detect changes in sleep following cognitive behavioral therapy for insomnia (CBT-I). Methods: Adults with insomnia and fibromyalgia (n = 113) were randomized to CBT-I, CBT for pain, or waitlist control. At baseline and posttreatment, participants completed one night of PSG and two weeks of diaries/actigraphy. Results: At baseline, objective measures estimated lower SOL, higher TST, and higher SE than diaries (ps < 0.05). Compared to PSG, actigraphic estimates were higher for SOL and lower for WASO (ps < 0.05). Repeated measures ANOVAs were conducted for the CBT-I group (n = 15), and significant method by time interactions indicated that the assessment methods differed in their sensitivity to detect treatment-related changes. PSG values did not change significantly for any sleep parameters. However, diaries showed improvements in SOL, WASO, and SE, and actigraphy also detected the WASO and SE improvements (ps < 0.05). Conclusions: Actigraphy was generally more concordant with PSG than with diaries, which are the recommended assessment for diagnosing insomnia. However, actigraphy showed greater sensitivity to treatment-related changes than PSG; PSG failed to detect any improvements, but actigraphy demonstrated changes in WASO and SE, which were also found with diaries. In comorbid insomnia/fibromyalgia, actigraphy may therefore have utility in measuring treatment outcomes. Keywords: insomnia, fibromyalgia, chronic pain, assessment, actigraphy, polysomnography, cognitive behavioral therapy, clinical trial Citation: Mundt JM, Crew EC, Krietsch K, Roth AJ, Vatthauer K, Robinson ME, Staud R, Berry RB, McCrae CS. Measuring treatment outcomes in comorbid insomnia and fibromyalgia: concordance of subjective and objective assessments. J Clin Sleep Med 2016;12(2):215-223. I NTRO DUCTI O NChronic insomnia is a primarily subjective disorder that is defined by self-reported difficulty falling asleep, staying asleep, awakening too early, or experiencing sleep that is routinely non-restorative and accompanied by at least one of many possible daytime impairments (e.g., mood disturbance, daytime sleepiness, fatigue or malaise).1 The high prevalence of chronic insomnia among patients with chronic pain has been well-established, with reported rates of insomnia as high as 88% in this population.2,3 Independently, sleep and pain are known to be associated with a host of negative consequences including decreased quality of life, mood disturbance, impaired quality of social interactions, dependence on medication, and cognitive dysfunction. However, these consequences are often exacerbated in chronic pain patients with comorbid insomnia. [...

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Alpha sleep characteristics in fibromyalgia

Cited by 230 publications

References 62 publications

Effects of Sodium Oxybate on Sleep Physiology and Sleep/Wake-related Symptoms in Patients with Fibromyalgia Syndrome: A Double-blind, Randomized, Placebo-controlled Study

Effects of Sodium Oxybate on Sleep Physiology and Sleep/Wake-related Symptoms in Patients with Fibromyalgia Syndrome: A Double-blind, Randomized, Placebo-controlled Study

Use of Phytoestrogens for the Treatment of Psychiatric Symptoms Associated with Menopause Transition

Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments

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