Sleep Disturbance in Fibromyalgia

Fibromyalgia (FM), characterized by diffuse myalgia, multiple topographically specific tender points, chronic fatigue, psychosocial distress, and disturbed, unrefreshing sleep, is a significant health problem. Clinical survey studies suggest that the majority of FM patients present with insomnia complaints, including difficulty initiating sleep, sleep maintenance problems, or persistent nonrestorative sleep. Studies of clinical FM patients have shown that a worsening of sleep enhances subsequent daytime distress and pain complaints, whereas exacerbations of daytime pain or psychosocial distress often are followed by increased nocturnal sleep disruption. Given such findings, it seems reasonable to speculate that sleep disturbance is mechanistically important to the etiology or symptom maintenance of the FM syndrome. This article provides an overview of FM-related sleep difficulties and their treatment.