Fibromyalgia (FM) is a complex chronic pain disorder and many patients report poor quality sleep, along with fatigue, distress, and cognitive problems. Sleep disturbances in FM have been extensively studied and are considered secondary to abnormalities of central nervous system pain processing or stress responses. Yet, improvement in sleep quality is an important therapeutic goal and success, with attendant improved quality of life, often enables patients to cope more effectively. This article provides an overview of what is known about sleep disturbances in FM and practical ways to assess sleep problems and improve sleep quality.
Insomnia and FM
Insomnias are both a cluster of symptoms and complex disorders of poor sleep quality often associated with an inadequate amount of sleep. Insomnia symptoms include difficulty falling asleep (long sleep latency), frequent awakenings (fragmented sleep), prolonged nighttime awakenings, or awakening too early and not being able to fall back to sleep. Insomnias occur when an individual has an adequate amount of time for sleep and are associated with various health consequences. The most common daytime complaints are fatigue, mood disturbance (anxiety and depression), decreased motivation, impaired memory, and work performance. Fatigue is more common than daytime sleepiness in primary insomnia. Individuals with insomnia generally are less healthy or satisfied with their health compared with good sleepers. Insomnia is associated with reduced quality of life and social functioning and has been associated with increased risk for heart disease and psychiatric disordersin particular, depression. Insomnia also is often a co-morbid condition with various psychiatric and medical conditions such as depression, arthritis, fibromyalgia, heart failure, chronic fatigue syndrome, pulmonary and gastrointestinal disorders. It remains unclear if treatment of the underlying condition improves insomnia or whether improving sleep ameliorates or reduces symptoms of the underlying condition. Insomnia also contributes to substance abuse problemsin particular, alcoholism. Common types of insomnia are summarized in Table 1.
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