Sleep Disturbances in Fibromyalgia Distinct From Primary Insomnia

New research published in the Clinical Journal of Pain suggests that sleep in patients with fibromyalgia (FM) is characterized by more frequent but briefer wake bouts compared to patients with primary insomnia or no sleep disorder. Study participants with FM appeared to have intact innate homeostatic sleep drives when compared to those with primary insomnia.

The combination of decreased latency to persistent sleep and slow-wave sleep, and increased frequency of wake and sleep bouts and decreased wake bout duration contributed to the report’s findings.

“This post hoc analysis demonstrates that the nature of sleep disturbance among patients with FM reporting difficulty with sleep can be distinguished from patients with primary insomnia and from controls,” the authors wrote. “We demonstrate that despite comparable wake time during the night (WASO), FM patients can be differentiated from patients with primary insomnia and from controls without sleep difficulties, on the basis of frequency and duration of wake or sleep bout episodes.”

The researchers examined 132 patients with FM who reported having difficulty sleeping, 109 patients with primary insomnia, and 52 patients who reported no sleep disturbance. Study participants were primarily female, with mean ages being 48.4, 45.4, and 30.2 years in the 3 cohorts, respectively.

Patients with FM showed more frequent (+ 5.92; P=.0075) and shorter wake bouts (–1.23 min; P=.0016) than those with primary insomnia. The investigators found that age was a significant variable in the shorter duration of wake bouts between patients with FM and patients with primary insomnia (P=.0085).

Summary and Clinical Applicability

The data from this study indicates that patients with FM have intact homeostatic sleep drives when compared to patients with primary insomnia, as these patients with FM returned to sleep relatively soon after awakening during the course of a sleep cycle.  So, despite shorter total mean duration of sleep bouts in both FM and primary insomnia patients, patients with FM had shorter wake bouts. 

“We feel these characteristics, in addition to broadening our understanding of the sleep disturbances in these populations, may have relevance in terms of the pathophysiology of the sleep disturbance as well as differential treatment practices for physicians evaluating and managing disrupted sleep in patients with fibromyalgia or those with primary insomnia,” the authors wrote.

Reference

Roth T, Bhadra-brown P, Pitman VW, Roehrs TA, Resnick EM. Characteristics of Disturbed Sleep in Patients With Fibromyalgia Compared With Insomnia or With Pain-Free Volunteers. Clin J Pain. 2016;32(4):302-7.

This article originally appeared on Neurology Advisor