Sleep physiology and psychological aspects of the fibrositis (fibromyalgia) syndrome.

Abstract

Fibrositis (fibromyalgia) patients were compared with normal controls in terms of electrophysiology (EEC), self-report indicants of awakening, quality of sleep, behaviourally signalled awakenings, and Symptom Check List 90R (SCL-90R) scores. The results differentiated fibrositis patients from normal controls in terms of SCL-90R scores, with fibrositis patients showing significantly more psychopathology. Fibrositis patients had more alpha EEG sleep and less REM and Stage 1 sleep. They were better able to recall their behaviourally signalled awakenings the following morning and reported qualitatively less satisfying sleep than the normal controls. The alpha EEG sleep anomaly may reflect a vigilant arousal state during nocturnal sleep and result in the daytime experience of unrefreshing sleep, psychologic distress, that re-enforces the perpetuation of the sleep-related symptoms.

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

“…Compared with historical measures in healthy subjects of similar age 43 , there was a high prevalence of disrupted non-REM sleep and alpha EEG sleep disorder 14 , and periodic sleep disturbances as shown by elevated CAP frequency, sleep-disordered breathing, and sleep-related periodic limb movements of sleep in subjects who were evaluated by PSG. The total CAP rate of 62.7% in these patients was substantially higher than in the 41% to 45% reported for normal subjects 18 , suggesting the occurrence of greater spontaneous arousability, poorer sleep quality, and greater sleep instability and fragmentation in patients with FM.…”

“…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 . The anomaly was not reported in a recent small-scale study that focused on the presence of alpha EEG during a selected component of non-REM sleep, i.e., delta EEG sleep [or slow-wave sleep (SWS)] 15 .…”

Sleep Disorders in Fibromyalgia Syndrome

“…The two main stages of sleep are rapid eye movement (REM) sleep, which is believed to be important for processing and memory consolidation of cognitive stimuli encountered while awake [12], and non-REM sleep, which the American Academy of Sleep Medicine classification currently divides into three stages (N1, N2 and N3), although previously there were four stages [13] [30][31][32][33]. It was also hypothesised that EEG alpha activity could be a sleep maintaining or a sleep disrupting factor depending on which part of the brain it comes from Pivik et al [34].…”

Sodium Oxybate: A Potential New Pharmacological Option for the Treatment of Fibromyalgia Syndrome

“…The presence of this alpha activity that is associated with wakefulness is thought to be indicative of a 'hypervigilent' state of sleep. This, in turn, results in the subjective feeling of nonrefreshing or nonrestorative sleep [Anch et al 1991].…”