The association between pain and sleep in fibromyalgia

Keskindağ, Buse; Karaaziz, Meryem

doi:10.15537/smj.2017.5.17864

Cited by 46 publications

(39 citation statements)

References 85 publications

(195 reference statements)

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“…Seven studies investigated populations living in the United States of America [29][30][31][32][33][34][35]; five from Spain [36][37][38][39][40], two from Italy [41,42], and one from each of Portugal [43], Pakistan [44], Finland [45], Austria [46], France [47], Brazil [48], Turkey [49] and the United Kingdom [50]. Participants in 18 of the 22 studies were diagnosed using the 1990 ACR diagnostic criteria [10], one study used the 2010 ACR criteria [11], one used the modified 2010/2011 ACR criteria [12], and two used a combination of 1990 and 2010. In 16 of the 22 studies (73%) participants were both randomised and blinded.…”

Section: Resultsmentioning

confidence: 99%

“…The experienced pain not only reduces overall quality of life but also has a significant impact on basic functions such as sleep and cognitive ability. This in turn exacerbates pain severity, leading to a "vicious-circle" of symptomatology and mental health problems, and a key feature of conditions characterised by central sensitisation [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis

et al. 2020

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Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with Chlorella green algae, coenzyme Q10, acetyl-l-carnitine or a combination of vitamin C and E significantly improved measures of pain. Interpretation of these studies was limited due to the frequent poor quality of the study design, the wide heterogeneity between studies, the small sample size and a high degree of bias. Therefore, there is insufficient evidence to recommend any one particular nutritional intervention for the management of fibromyalgia and further research is needed.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis

et al. 2020

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“…Sleep disturbance is a major symptom, and is relatively prevalent in patients with fibromyalgia (Jacobson et al, 2015;Moldofsky, 2008;Spaeth, Rizzi, & Sarzi-Puttini, 2011). Several studies have shown that poor sleep is associated with pain severity (Choy, 2015;Keskindag & Karaaziz, 2017;Mork & Nilsen, 2012) and poor cognitive performance (Backhaus et al, 2006;Fortier-Brochu & Morin, 2014;Fulda & Schulz, 2001).…”

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confidence: 99%

Subjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia

Fang

Chen

et al. 2019

Journal of Sleep Research

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Pain severity and sleep are associated with cognitive performance in patients with fibromyalgia. This study examined whether sleep mediates the relationships of pain severity with psychomotor vigilance and attention in patients with fibromyalgia by analysing 80 patients with fibromyalgia. Cognitive performance, pain severity and sleep parameters were determined using the Psychomotor Vigilance Task, Brief Pain Inventory–Short Form and sleep diaries of seven consecutive nights, respectively. The patients’ demographic data were analysed for potential confounding factors. After adjustment for these confounders, a series of regression analyses was performed to examine the mediating role of sleep. The results indicated that higher pain severity was strongly associated with poorer sustained attention and lower sleep quality, the total effects of pain severity on psychomotor vigilance and attention were significant (c path: β = 0.23, p = 0.04), and pain severity was a significant sleep quality predictor (a path: β = −0.33, p < 0.01). When sleep quality was entered into the regression model (a × b path), the effects of pain severity on psychomotor vigilance and attention became non‐significant (c′ path: β = 0.15, p = 0.20) after adjustment of age, indicating a complete mediating effect of sleep quality in the pain severity–cognitive performance relationship. In conclusion, sleep quality mediates the pain severity–cognitive performance relationship: pain affects sleep quality, which in turn impairs sustained attention. Our findings provide further insight into the processes underlying the relationship between pain and poor cognitive function. Improved sleep quality may offset the detrimental effects of pain on sustained attention.

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“…Although the SQ-NRS is as valid and reliable as the other included PROMs, using tools such as the PSQI, the JSS, and the MOS-SS which permit a more comprehensive evaluation of sleep quality, could provide more accurate information on the effects of new interventions on specific sleep quality aspects and how these aspects relate with other FM symptoms. In this regard, the PSQI is the most widely used PROM among the existing literature in the field of FM, providing relevant information about both the relationship of poor sleep quality to other symptoms of this health condition [30][31][32][33] and the effects of different treatment approaches [34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Patient Reported Outcome Measures of Sleep Quality in Fibromyalgia: A COSMIN Systematic Review

Climent‐Sanz

Marco-Mitjavila

Pastells-Peiró

et al. 2020

IJERPH

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Poor sleep quality is a common concern and a troublesome symptom among patients suffering from fibromyalgia. The purpose of this review was to identify and describe the available patient reported outcome measures (PROMs) of sleep quality validated in adult people diagnosed with fibromyalgia. The COSMIN and PRISMA recommendations were followed. An electronic systematized search in the electronic databases PubMed, Scopus, CINAHL Plus, PsycINFO, and ISI Web of Science was carried out. Validation studies of PROMs of sleep quality in fibromyalgia published in English or Spanish were included. The selection of the studies was developed through a peer review process through the online software "COVIDENCE". The quality of the studies was assessed using the COSMIN Risk of Bias checklist. A total of 5 PROMs were found validated in patients with fibromyalgia: (1) Pittsburgh Sleep Quality Index (PSQI), (2) Jenkins Sleep Scale (JSS), (3) Sleep Quality Numeric Rating Scale (SQ-NRS), (4) Medical Outcomes Study-Sleep Scale (MOS-SS), and (5) Fibromyalgia Sleep Diary (FSD). The quality of the evidence was very good and the quality of the results ranged from moderate to high. All the included PROMs, except for the FSD, showed adequate psychometric properties and, therefore, are valid and reliable tools for assessing sleep quality in the context of FM. However, none of the studies analyzed all the psychometric properties of the included PROMs as established in the COSMIN guidelines, highlighting that this is a potential field of research for future investigations. out in all experimental studies about FM. These results are in line with a previous internet survey, including 2596 people with FM [4], showing that poor sleep quality, together with pain, fatigue and morning stiffness, are the symptoms with greater severity and impact in these patients. Specifically, 79% of the participants perceived that sleep problems were one of the most common factors in the exacerbation of FM symptoms [4].In terms of prevalence, the studies indicate that between 65% and 99% of people diagnosed with FM report poor sleep quality [5][6][7]. Other authors [8] state that 63% of these patients report two or more symptoms of difficulty sleeping, while only 11.2% report having no problem sleeping. A recent meta-analysis of case-control studies indicated that, in comparison with healthy controls, people with FM show significantly lower sleep efficiency and sleep quality, shorter sleep duration, longer wake time after sleep onset and more percentage of light sleep stages when assessed with polysomnography. Subjective assessment showed that patients with FM have more difficulties falling asleep and worse sleep efficiency. Therefore, and although there are no conclusive data regarding the prevalence of poor sleep quality in FM, the results presented reveal that it is a recurrent and a concerning symptom among these patients [9]. Furthermore, poor sleep quality has been shown to be related with increases in the intensity of pain, and it is an aggravating factor o...

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The association between pain and sleep in fibromyalgia

Cited by 46 publications

References 85 publications

Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis

Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis

Subjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia

Patient Reported Outcome Measures of Sleep Quality in Fibromyalgia: A COSMIN Systematic Review

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