Fatigue, sleep, and stress: dynamic relationships in fibromyalgia

Abstract

Background: Fibromyalgia (FMS) is a chronic pain syndrome characterized by fatigue and non-restorative sleep. Over 75% of individuals with FMS complain of fatigue and poor sleep. Purpose: The primary aim of this study was to compare 25 women with and 25 women without FMS, on fatigue; autonomic nervous system activity; perceived stress; sleep quality; and immune function. All participants complained of poor sleep, and had been referred to a sleep center for evaluation. The secondary aim was to explore the relationships among those variables within each group and compare those relationships between groups. Methods: A single stage cross-sectional design was used. Results: The FMS group reported greater fatigue, worse sleep, and more autonomic symptoms than the non-FMS group; they evidenced higher tumor necrosis factor alpha (TNF-α) levels. Non-FMS participants with obstructive sleep apnea (OSA) had higher interleukin 1-beta (IL-1β) values than the FMS group. In the FMS group, fatigue was positively correlated with stress, autonomic symptoms, and TNF-α; stress was positively correlated with autonomic symptoms; apnea-hypopnea index (AHI) was negatively correlated with IL-1β levels and total arousals. In the non-FMS group, fatigue was positively correlated with sleep quality; both variables were positively correlated with IL-1β. IL-1β was also positively correlated with TNF-α. Conclusions: Variables that were correlated in the FMS group differed from those in the non-FMS group, except for the correlation of total arousals with AHI.

Contextualizing goal preferences in fear-avoidance models. Looking at fatigue as a disabling symptom in fibromyalgia patients

“…As we have pointed out, in spite of pain often being the main symptom in the diagnosis of fibromyalgia, fatigue has been shown to be highly prevalent and persistent in these patients [24][25][26][27][28][29]. Although more that 75% of FM patients report fatigue [30], conceptualizing it as one of their most concerning symptoms that impact on quality of life [31,32], little is known regarding the psychosocial variables involved in its maintenance.…”

Hope and fatigue in chronic illness: The role of perceived stress

“…Such symptoms are particularly relevant for individuals experiencing inflammatory diseases; indeed, the linkage between inflammatory processes and fatigue is well established and may be the result of proinflammatory cytokine response (Collado-Hidalgo et al, 2006). As an example, more than 75 percent of individuals with fibromyalgia report sleep disturbances and fatigue and greater levels of stress than controls (McNallen et al, 2013). Similarly, approximately 70 percent of patients with arthritis and 40–70 percent of patients with inflammatory bowel disease (IBD) experience fatigue (Graff et al, 2011; Hewlett et al, 2011), and perceived stress is a frequent complaint.…”