Sunday, May 22, 2011

Sleep Disorders and Fibromyalgia

Note: Studies looking at the role of cytokines in sleep regulation and
physiological function suggest this is an area that should also be
included in any discussion of disordered sleep in fibromyalgia and
CFS. The effectiveness of CBT or sleep hygiene are a function of
whether they address the reason for the sleep dysfunction. The
abstract does not note what percentage of fibromyalgia patients find
these therapies effective or if they are only partially effecting
which might be the case if they address part of the problem, but do
not address the primary source of sleep dysfunction.

Further information on sodium oxybate can be found here:
http://chronicfatigue.about.com/od/treatingfmscfs/p/sodiumoxybate.htm

Curr Pain Headache Rep. 2011 May 20. [Epub ahead of print]  A reminder
that non-specific interventions such as CBT don't tell us

Sleep Disorders and Fibromyalgia.
Roizenblatt S, Neto NS, Tufik S.
Departamento de Psicobiologia, Universidade Federal de São Paulo,
Avenida Angélica 1996, Andar 1, São Paulo, 01228-200, Brazil,
suelyroi@gmail.com.

Abstract
Disordered sleep is such a prominent symptom in fibromyalgia that the
American College of Rheumatology included symptoms such as waking
unrefreshed, fatigue, tiredness, and insomnia in the 2010 diagnostic
criteria for fibromyalgia.

Even though sleep recording is not part of the routine evaluation,
polysomnography may disclose primary sleep disorders in patients with
fibromyalgia, including obstructive sleep apnea and restless leg
syndrome.
In addition, genetic background and environmental susceptibility link
fibromyalgia and further sleep disorders. Among nonpharmacological
treatment proposed for sleep disturbance in fibromyalgia, positive
results have been obtained with sleep hygiene and cognitive-behavioral
therapy.

The effect of exercise is contradictory, but overweight or obese
patients with fibromyalgia should be encouraged to lose weight.

Regarding the approved antidepressants, amitriptyline proved to be
superior to duloxetine and milnacipran for sleep disturbances.

New perspectives remain on the narcolepsy drug sodium oxybate, which
recently was approved for sleep management in fibromyalgia.