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Avichal Ughreja R, Venkatesan P, Balebail Gopalakrishna D, Preet Singh Y, Vani Lakshmi R. Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: A randomized controlled trial. JOURNAL OF INTEGRATIVE MEDICINE 2024:S2095-4964(24)00339-X. [PMID: 38955652 DOI: 10.1016/j.joim.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 04/11/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Sleep disturbance is commonly seen in fibromyalgia syndrome (FMS); however, high quality studies involving manual therapies that target FMS-linked poor sleep quality are lacking for the Indian population. OBJECTIVE Craniosacral therapy (CST), Bowen therapy and exercises have been found to influence the autonomic nervous system, which plays a crucial role in sleep physiology. Given the paucity of evidence concerning these effects in individuals with FMS, our study tests the effectiveness of CST, Bowen therapy and a standard exercise program against static touch (the manual placebo group) on sleep quality in FMS. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION A placebo-controlled randomized trial was conducted on 132 FMS participants with poor sleep at a hospital in Bangalore. The participants were randomly allocated to one of the four study groups, including CST, Bowen therapy, standard exercise program, and a manual placebo control group that received static touch. CST, Bowen therapy and static touch treatments were administered in once-weekly 45-minute sessions for 12 weeks; the standard exercise group received weekly supervised exercises for 6 weeks with home exercises until 12 weeks. After 12 weeks, all study participants performed the standard exercises at home for another 12 weeks. MAIN OUTCOME MEASURES Sleep quality, pressure pain threshold (PPT), quality of life and fibromyalgia impact, physical function, fatigue, pain catastrophizing, kinesiophobia, and positive-negative affect were recorded at baseline, and at weeks 12 and 24 of the intervention. RESULTS At the end of 12 weeks, the sleep quality improved significantly in the CST group (P = 0.037) and Bowen therapy group (P = 0.023), and the PPT improved significantly in the Bowen therapy group (P = 0.002) and the standard exercise group (P < 0.001), compared to the static touch group. These improvements were maintained at 24 weeks. No between-group differences were observed for other secondary outcomes. CONCLUSION CST and Bowen therapy improved sleep quality, and Bowen therapy and standard exercises improved pain threshold in the short term. These improvements were retained within the groups in the long term by adding exercises. CST and Bowen therapy are treatment options to improve sleep and reduce pain in FMS. TRIAL REGISTRATION NUMBER Registered at Clinical Trials Registry of India with the number of CTRI/2020/04/024551. Please cite this article as: Ughreja RA, Venkatesan P, Gopalakrishna DB, Singh YP, Lakshmi VR. Effectiveness of craniosacral therapy, Bowen therapy, static touch and standard exercise program on sleep quality in fibromyalgia syndrome: a randomized controlled trial. J Integr Med. 2024; Epub ahead of print.
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Affiliation(s)
- Reepa Avichal Ughreja
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Prem Venkatesan
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
| | | | - Yogesh Preet Singh
- Department of Clinical Immunology and Rheumatology, All India Institute of Medical Sciences, Bilaspur 174001, Himachal Pradesh, India
| | - R Vani Lakshmi
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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Serpas DG, Morton T, Zettel-Watson L, Cherry BJ. The role of pain intensity and depressive symptoms in the relationship between sleep quality and postural control among middle-aged and older adults with Fibromyalgia. Psychol Health 2024; 39:749-764. [PMID: 36134694 DOI: 10.1080/08870446.2022.2107644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 05/26/2022] [Accepted: 07/25/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Fibromyalgia (FM) is a chronic pain condition often accompanied by sleep problems and depression that are each associated with reduced physical ability including postural control. Research supports a sequential association between pain intensity and depression in FM, and poor sleep quality may play a key role in this relationship. This study aimed to verify a serial pattern of associations among sleep quality, pain intensity, and depressive symptoms and quantify these effects on objective postural control. DESIGN Community-residing adults diagnosed with FM (n = 155; Mage = 61.08, SD = 7.70; 93% female; 79% White) were included in this cross-sectional study. MAIN OUTCOMES Participants self-rated sleep quality (restorative sleep, sleep waking, and sleep latency), pain intensity, and depressive symptoms, and the Fullerton Advanced Balance (FAB) scale and 8-Foot Up and Go Test (8FUPGT) measured objective postural control. RESULTS Findings indicated that the serial association between pain intensity and depressive symptoms fully mediated the relationship between sleep quality and both FAB (95% CI [-.125, -.013]), and 8FUPGT (95% CI [.002, .033]) performance. CONCLUSION Findings highlight the serial association of pain intensity and depressive symptoms with objective postural control performance and the potential for sleep and depression interventions that may maximize functional outcomes in FM.
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Affiliation(s)
- Dylan G Serpas
- Department of Psychology, California State University, Fullerton, Fullerton, CA, USA
| | - Timothy Morton
- Department of Psychology, California State University, Fullerton, Fullerton, CA, USA
| | - Laura Zettel-Watson
- Department of Psychology, California State University, Fullerton, Fullerton, CA, USA
- Aging Studies Academic Program, California State University, Fullerton, Fullerton, CA, USA
| | - Barbara J Cherry
- Department of Psychology, California State University, Fullerton, Fullerton, CA, USA
- Aging Studies Academic Program, California State University, Fullerton, Fullerton, CA, USA
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Ughreja RA, Venkatesan P, Gopalakrishna DB, Singh YP, R VL. Sleep profile and its correlation with clinical variables in fibromyalgia syndrome: A cross-sectional study. J Taibah Univ Med Sci 2024; 19:90-98. [PMID: 37876596 PMCID: PMC10590848 DOI: 10.1016/j.jtumed.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/26/2023] [Accepted: 08/31/2023] [Indexed: 10/26/2023] Open
Abstract
Objective A scarcity of literature exists on sleep quality in fibromyalgia syndrome (FMS) in Indian patients. The current study described the sleep profile of patients with FMS with poor sleep quality residing in urban Bangalore and determined the relationship between poor sleep and fibromyalgia variables. Methods Eighty-six patients with FMS were included in the study. Pittsburgh Sleep Quality Index (PSQI) and Revised Fibromyalgia Impact Questionnaire (FIQR) were used to evaluate the sleep profile and fibromyalgia variables. Spearman's rank correlation, t-test, and one-way analysis of variance were used for the analyses. Results Ninety-one percent of patients with FMS were identified as poor sleepers (PSQI >5). The mean PSQI global score of the included patients was 12.04 ± 3.5. The global sleep score varied with sex (p = 0.003) and fibromyalgia severity (p = 0.001). A significant correlation was found between PSQI global score and FIQR total score (r = 0.4, p < 0.001), FIQR subdomains (r = 0.2-0.4, p < 0.05), and FMS duration (r = 0.26, p < 0.05). The PSQI global score was also correlated with pain, depression, memory, anxiety, balance, and sensitivity (r = 0.2-0.3, p < 0.05). Conclusion Sleep disturbance is highly prevalent in patients with FMS residing in urban Bangalore. Sleep quality tends to worsen in females with increasing FMS severity and duration but does not differ across other demographic variables. Sleep quality is significantly correlated with somatic as well as psychological variables. Future studies evaluating the predictors of poor sleep are needed to further corroborate these findings.
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Affiliation(s)
- Reepa A. Ughreja
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Prem Venkatesan
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Yogesh P. Singh
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Vani Lakshmi R
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Sauch Valmaña G, Miró Catalina Q, Carrasco-Querol N, Vidal-Alaball J. Gender, Mental Health and Socioeconomic Differences in Fibromyalgia: A Retrospective Cohort Study Using Real-World Data from Catalonia. Healthcare (Basel) 2023; 11:healthcare11040530. [PMID: 36833067 PMCID: PMC9957461 DOI: 10.3390/healthcare11040530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
The main objective of our study was to assess the associated risk between fibromyalgia (FM) and the incidence of the diagnosis of anxiety and depression in the general population during the years 2010-2017 in Catalonia. METHOD A retrospective cohort study was designed using the Information System for Research Development in Primary Care database. All patients with FM were included (n = 56,098) and matched to the control group in a 1:2 pairing ratio (n = 112,196). The demographic variables studied were sex, age and socio-economic status. RESULTS Patients with FM have a lower survival rate if they are also diagnosed with anxiety and depression during the entire study period, with the rate being 26.6% lower in FM patients at an 8-year follow-up (0.58, 95%CI: 0.57-0.59 vs. 0.79, 95%CI: 0.78-0.79). There is a 58% reduction in the risk of developing anxiety and/or depression in the control group vs. the FM group (p-value < 0.05), and by 45% in male vs. female sex (p-value < 0.05). CONCLUSIONS FM is a disease that is associated with anxiety and depression, and men are at lower risk of anxiety and depression after FM diagnosis.
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Affiliation(s)
- Glòria Sauch Valmaña
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08272 Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain
- Correspondence:
| | - Queralt Miró Catalina
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08272 Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain
| | - Noèlia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08272 Barcelona, Spain
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08272 Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08272 Barcelona, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia, 08500 Vic, Spain
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Kulshreshtha P, Deepak KK. Personality construct as a biomarker in fibromyalgia: A narrative review from an autonomic rehabilitation perspective. J Back Musculoskelet Rehabil 2023; 36:1251-1260. [PMID: 37482976 DOI: 10.3233/bmr-220353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
BACKGROUND The heterogeneity of symptoms and ineffective treatment raise questions about the current diagnostic criteria of fibromyalgia (FM). Misdiagnosis of FM often leads to less than efficacious treatment and poor quality of life. OBJECTIVE This article reviews relevant evidence-based literature on personality traits in FM patients with an autonomic dysfunction perspective based on a hierarchical model to explain the utility of considering the personality trait in FM diagnosis. METHODS A narrative review of articles concerning chronic pain, FM, and personality traits with respect to autonomic dysfunction in FM was conducted after extensive relevant literature searches. RESULTS Reports discussing the predisposing factors, including coping styles, anger, suicide risk, a lack of physical activity and social support, in maintaining persistent pain in FM exist. Relationships between pain duration and severity and personality traits like neuroticism and extraversion have been reported. Coexisting clinical manifestations of FM like sleep disorders, anxiety, and intestinal irritability indicate autonomic dysfunction. CONCLUSIONS This article lays out a constructive framework for individualized and personalized medicine for the effective rehabilitation of FM patients. The quest to find a definitive diagnosis of FM should include personality biomarkers that might translate into personalized medicine. An individualistic approach may bank upon artificial intelligence algorithms for both diagnostic as well as prognostic purposes in FM.
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Andrade A, Steffens RDAK, Grisard F, Liz CMD, Brandt R, Coimbra DR, Bevilacqua GG. STRENGTH TRAINING IN PATIENTS WITH FIBROMYALGIA: A FEASIBILITY STUDY. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-869220232901176543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Fibromyalgia syndrome (FM) is characterized by the presence of diffuse pain lasting for more than three months and is often associated with sleep disorders. Studies have investigated the effect of strength training (ST) on pain and sleep quality in FM patients, but there continue to be diverse perspectives on the effects of this intervention in this population. Objective: The aim of the study was to examine the effects of strength training (ST) on pain and sleep quality in FM patients. Methods: Forty-eight women with FM participated in the study between August and October, 2012. Six (55±6.5 years) performed ST, conducted at Santa Catarina State University, and eight (47±9 years) comprised the control group. The Socio-Demographic and Clinical Questionnaire, the visual analog scale (VAS) for pain, and the Pittsburgh Sleep Quality Index were used. Data were collected before the first session and after the eight-week intervention and were analyzed using descriptive statistics and inferential tests. Results: The eight- week ST intervention decreased pain (p< 0.05) and significantly diminished the daytime sleep dysfunctions (p< 0.05), demonstrating that the proposed program contributes to improving patient quality of life. Conclusion: ST is a feasible treatment for patients with fibromyalgia. Level of evidence II; Therapeutic study.
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Maestre-Cascales C, Castillo-Paredes A, Romero-Parra N, Adsuar JC, Carlos-Vivas J. Gradual Strength Training Improves Sleep Quality, Physical Function and Pain in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15662. [PMID: 36497737 PMCID: PMC9793755 DOI: 10.3390/ijerph192315662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Fibromyalgia (FM) is characterized by chronic and generalized musculoskeletal pain. There is currently no cure for FM, but alternative treatments are available. Among them, gradual strength training programs (ST) which on daily activities are a valid option to improve some of the pronounced symptoms of FM that affect quality of life, such as fatigue, pain, sleep quality, and physical function. However, there is a need for more information on optimal training programs to improve anxiety and fatigue symptoms. AIM To analyze the effects of a 24-week gradual and progressive ST on sleep quality, fatigue, pain domains, physical function, and anxiety-state. METHODS 41 women with FM participated in the 24 weeks of intervention based on gradual and progressive ST. Two, 60 min, training sessions per week were con-ducted. Participants were evaluated before the ST program (week 0), in week 12 and at the end of the ST program (week 24). The Revised Fibromyalgia Impact Questionnaire was used to assess sleep quality and fatigue scales. Anxiety-state was evaluated with the State Anxiety Inventory, and pain domains by means of the Brief Pain Inventory. Senior Fitness Test was used for physical function measurements. One-way analysis of variance (ANOVA) was applied to assess the mean differences between phases, and Spearman's correlations were used to assess the associations between physical and psychological symptoms, and physical function. RESULTS The results demonstrated that 24 weeks of ST improves physical function, sleep quality and pain domains (p ≤ 0.05). Higher anxiety and pain interference scores were related to worsening physical function. CONCLUSIONS Gradual ST significantly improves sleep quality, pain, and physical function, but not anxiety and fatigue.
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Affiliation(s)
- Cristina Maestre-Cascales
- LFE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Antonio Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago 8370040, Chile
| | - Nuria Romero-Parra
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Science, King Juan Carlos University, 28922 Alcorcón, Spain;
| | - José Carmelo Adsuar
- Promoting a Healthy Society Research Group (PHeSo), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Jorge Carlos-Vivas
- Physical Activity for Education, Performance and Health (PAEPH) Research Group, Faculty of Sports Sciences, University of Extremadura, 10003 Cáceres, Spain;
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The Affective Dimension of Pain Appears to Be Determinant within a Pain-Insomnia-Anxiety Pathological Loop in Fibromyalgia: A Case-Control Study. J Clin Med 2022; 11:jcm11123296. [PMID: 35743367 PMCID: PMC9225613 DOI: 10.3390/jcm11123296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Fibromyalgia (FM) is a chronic pain disease characterized by multiple symptoms whose interactions and implications in the disease pathology are still unclear. This study aimed at investigating how pain, sleep, and mood disorders influence each other in FM, while discriminating between the sensory and affective pain dimensions. Methods: Sixteen female FM patients were evaluated regarding their pain, while they underwent—along with 11 healthy sex- and age-adjusted controls—assessment of mood and sleep disorders. Analysis of variance and correlations were performed in order to assess group differences and investigate the interactions between pain, mood, and sleep descriptors. Results: FM patients reported the typical widespread pain, with similar sensory and affective inputs. Contrary to controls, they displayed moderate anxiety, depression, and insomnia. Affective pain (but neither the sensory pain nor pain intensity) was the only pain indicator that tendentially correlated with anxiety and insomnia, which were mutually associated. An affective pain–insomnia–anxiety loop was thus completed. High ongoing pain strengthened this vicious circle, to which it included depression and sensory pain. Conclusions: Discriminating between the sensory and affective pain components in FM patients disclosed a pathological loop, with a key role of affective pain; high ongoing pain acted as an amplifier of symptoms interaction. This unraveled the interplay between three of most cardinal FM symptoms; these results contribute to better understand FM determinants and pathology and could help in orienting therapeutic strategies.
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Yabe Y, Hagiwara Y, Sekiguchi T, Sugawara Y, Tsuchiya M, Yoshida S, Tsuji I. Sleep disturbance is associated with neck pain: a 3-year longitudinal study after the Great East Japan Earthquake. BMC Musculoskelet Disord 2022; 23:459. [PMID: 35578231 PMCID: PMC9109362 DOI: 10.1186/s12891-022-05410-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/09/2022] [Indexed: 11/11/2022] Open
Abstract
Background Neck pain is a common health problem in the general population as well as in people after natural disasters. Sleep disturbances are gaining attention as risk factors for musculoskeletal pain; however, the association between sleep disturbance and neck pain has not been clarified. The present study aimed to clarify the association between sleep disturbance and neck pain, especially focusing on the effect of the duration of sleep disturbance, after the Great East Japan Earthquake. Methods This study used 3-year longitudinal data obtained from individuals (n = 2,059) living in disaster-affected areas after the Great East Japan Earthquake. Sleep disturbance and neck pain were investigated at 4, 5, 6, and 7 years after the disaster. Multivariate logistic regression analyses were used for the assessment. Results Sleep disturbance was significantly associated with neck pain, and the association was stronger as the duration of sleep disturbance increased (adjusted odds ratios [95% confidence intervals]: 1.84 [1.23–2.75] for “ < 1 year”; 2.41 [1.53–3.81] for “ ≥ 1 year and < 2 years”; 2.80 [2.09–3.76] for “ ≥ 2 years”). Furthermore, preceding sleep disturbance was significantly associated with the onset of neck pain, and the association was stronger as the duration of sleep disturbance increased (adjusted odds ratios [95% confidence intervals]: 1.86 [1.08–3.20] for “ < 1 year”; 2.39 [1.22–4.70] for “ ≥ 1 year and < 2 years”; 3.00 [1.94–4.65] for “ ≥ 2 years”). Conclusions Sleep disturbance is associated with neck pain, and long-lasting sleep disturbance strengthens the association. Clinicians should consider this association to effectively treat patients with neck pain, especially those affected by natural disasters.
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Affiliation(s)
- Yutaka Yabe
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Yoshihiro Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Takuya Sekiguchi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Masahiro Tsuchiya
- Department of Nursing, Faculty of Health Science, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, Miyagi, 981-8522, Japan
| | - Shinichirou Yoshida
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Whale K, Dennis J, Wylde V, Beswick A, Gooberman-Hill R. The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis. BMC Musculoskelet Disord 2022; 23:440. [PMID: 35546397 PMCID: PMC9092772 DOI: 10.1186/s12891-022-05318-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/24/2022] [Indexed: 02/25/2023] Open
Abstract
Objective About two thirds of people with chronic pain report problems sleeping. We aimed to evaluate the effectiveness of non-pharmacological sleep interventions for improving sleep in people with chronic pain. Design We conducted a systematic review of non-pharmacological and non-invasive interventions to improve sleep quality or duration for adults with chronic non-cancer pain evaluated in a randomised controlled trial. Our primary outcome of interest was sleep; secondary outcomes included pain, health-related quality of life, and psychological wellbeing. We searched the Cochrane Library, MEDLINE, Embase, PsycINFO and CINAHL from inception to April 2020. After screening, two reviewers evaluated articles and extracted data. Meta-analysis was conducted using a random effects model. Risk of bias was assessed with the Cochrane tool. Results We included 42 trials involving 3346 people randomised to 94 groups, of which 56 received an intervention targeting sleep. 10 studies were of fair and 32 of good methodological quality. Overall risk of bias was judged to be low in 11, high in 10 and unclear in 21 studies. In 9 studies with 385 people randomised, cognitive behavioural therapy for insomnia showed benefit post-treatment compared with controls for improved sleep quality, standardised mean difference − 1.23 (95%CI -1.76, − 0.70; p < 0.00001). The effect size was only slightly reduced in meta-analysis of 3 studies at low risk of bias. The difference between groups was lower at 3 and 6 months after treatment but still favoured cognitive behavioural therapy for insomnia. Pain, anxiety and depression were reduced post-treatment, but evidence of longer term benefit was lacking. There was no evidence that sleep hygiene interventions were effective in improving sleep and there was some evidence in comparative studies to suggest that cognitive behavioural therapy for insomnia was more effective than sleep hygiene. Numerous other interventions were evaluated in small numbers of studies, but evidence was insufficient to draw conclusions about effectiveness. Conclusions Cognitive behavioural therapy for insomnia is an effective treatment to improve sleep for people with chronic pain, but further high-quality primary research is required to explore combined CBT content that will ensure additional improvements to pain, quality of life and psychological health and longer-term maintenance of benefits. Primary research is also needed to evaluate the effectiveness of interventions for which insufficient evidence exists. Trial registration PROSPERO registration number: CRD42019093799. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05318-5.
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Affiliation(s)
- Katie Whale
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK. .,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Jane Dennis
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Vikki Wylde
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Andrew Beswick
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Rachael Gooberman-Hill
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Level 1, Southmead Hospital, Bristol, BS10 5NB, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
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Ditmer M, Gabryelska A, Turkiewicz S, Białasiewicz P, Małecka-Wojciesko E, Sochal M. Sleep Problems in Chronic Inflammatory Diseases: Prevalence, Treatment, and New Perspectives: A Narrative Review. J Clin Med 2021; 11:jcm11010067. [PMID: 35011807 PMCID: PMC8745687 DOI: 10.3390/jcm11010067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 12/12/2022] Open
Abstract
Epidemiological studies have shown that individuals with sleep problems are at a greater risk of developing immune and chronic inflammatory diseases. As sleep disorders and low sleep quality in the general population are frequent ailments, it seems important to recognize them as serious public health problems. The exact relation between immunity and sleep remains elusive; however, it might be suspected that it is shaped by others stress and alterations of the circadian rhythm (commonly caused by for example shift work). As studies show, drugs used in the therapy of chronic inflammatory diseases, such as steroids or monoclonal antibodies, also influence sleep in more complex ways than those resulting from attenuation of the disease symptoms. Interestingly, the relation between sleep and immunity appears to be bidirectional; that is, sleep may influence the course of immune diseases, such as inflammatory bowel disease. Thus, proper diagnosis and treatment of sleep disorders are vital to the patient's immune status and, in effect, health. This review examines the epidemiology of sleep disorders and immune diseases, the associations between them, and their current treatment and novel perspectives in therapy.
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Affiliation(s)
- Marta Ditmer
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Szymon Turkiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
| | - Ewa Małecka-Wojciesko
- Department of Digestive Tract Diseases, Medical University of Lodz, 92-215 Lodz, Poland;
| | - Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (M.D.); (A.G.); (S.T.); (P.B.)
- Correspondence: ; Tel.: +48-42-678-18-00
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12
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Velasco L, López-Gómez I, Gutiérrez L, Écija C, Catalá P, Peñacoba C. Exploring the Preference for Fatigue-avoidance Goals as a Mediator Between Pain Catastrophizing, Functional Impairment, and Walking Behavior in Women With Fibromyalgia. Clin J Pain 2021; 38:182-188. [PMID: 34928869 DOI: 10.1097/ajp.0000000000001010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Along with the symptoms of pain and fatigue, pain catastrophizing and avoidance behaviors are highly prevalent and associated with functional impairment in fibromyalgia (FM) patients. Although pain and fatigue affect patients' quality of life, research has been exclusively focused on how pain affects physical activity and exercise. The aim of this study was to analyze the role of pain catastrophizing and preference for fatigue-avoidance goals in walking behavior and functional impairment in women with FM. MATERIALS AND METHODS In this cross-sectional study the sample was composed of 76 participants aged 18 years and older (mean age=55.05, SD=7.70). The study evaluated pain catastrophizing, preference for fatigue-avoidance goals, functional impairment, and walking behavior along with sociodemographic variables and clinical data. RESULTS Pain catastrophizing was associated with preference for fatigue-avoidance goals and this preference was associated with greater functional impairment and less distance walked. Path analysis supported the mediating role of preference for fatigue-avoidance goals in the relationship between pain catastrophizing and walking behavior and between pain catastrophizing and functional impairment. Furthermore, pain catastrophizing predicted greater preference for fatigue-avoidance goals which predicted more problems in functioning and less distance walked. DISCUSSION The present study may help clarify the connection between the factors that stop individuals with FM from implementing beneficial behaviors such as walking, and thus, allowing for the design of psychological interventions that seek to maintain physical functioning despite experiencing fatigue.
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Affiliation(s)
- Lilian Velasco
- Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain
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13
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Sheila B, Octavio LR, Patricia C, Dolores B, Lilian V, Cecilia P. Perfectionism and Pain Intensity in Women with Fibromyalgia: Its Influence on Activity Avoidance from The Contextual Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228442. [PMID: 33202698 PMCID: PMC7698249 DOI: 10.3390/ijerph17228442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/25/2022]
Abstract
Given the scarcity of studies regarding perfectionism from a contextual perspective, this study aims to analyze its role in the relationship between pain and activity avoidance and its differential effect among patients with different fibromyalgia severity. A cross-sectional study with 228 women with fibromyalgia classified into two disease severity groups (low/moderate vs. high) was carried out. Moderation analyses were conducted; perfectionism was used as moderator, pain (in high and low pain situations) as independent variable, and activity avoidance as the outcome. Among the high disease severity group, analyses showed direct contributions of perfectionism (p < 0.001) but not of pain (p > 0.05); moderation effects were found in high pain situations (p = 0.002) (for low levels of perfectionism, a positive association was found between pain intensity and avoidance). Among the low severity group, direct effects of perfectionism (p < 0.05) and pain intensity (p = 0.04) were found (although the latter only for high pain situations); moderation effects were found in high pain situations (p = 0.018) (for high levels of perfectionism a positive and significant association was found between pain intensity and avoidance). Perfectionism has been found to be a key variable in the differential relationship between pain intensity (in high pain situations) and activity avoidance in groups with high and low disease severity.
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Affiliation(s)
- Blanco Sheila
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Luque-Reca Octavio
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Catala Patricia
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Bedmar Dolores
- Pain Unit, Hospital Universitario de Fuenlabrada, 28944 Fuenlabrada, Madrid, Spain;
| | - Velasco Lilian
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
| | - Peñacoba Cecilia
- Department of Psychology, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (B.S.); (L.-R.O.); (C.P.); (V.L.)
- Correspondence: ; Tel.: +34-91-488-88-64
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14
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Sleep hygiene in shift workers: A systematic literature review. Sleep Med Rev 2020; 53:101336. [PMID: 32593135 DOI: 10.1016/j.smrv.2020.101336] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/21/2022]
Abstract
In response to demand for the '24/7' service availability, shift work has become increasingly common. Given their non-traditional working hours, shift workers sleep at non-traditional times, with significant research undertaken to understand shift worker sleep. However, sleep hygiene in shift workers has been paid little research attention. To investigate shift worker engagement with sleep hygiene, a systematic review using the databases Sage, ScienceDirect, and Scopus was undertaken. The search terms utilised were: shift work, shiftwork, shift-work, sleep hygiene, sleep routine, and sleep habit. Sixteen studies were included for review. Findings show that shift workers frequently report caffeine consumption and daytime napping, in line with best-practice fatigue-management strategies, but contrary to existing sleep hygiene recommendations. Shift workers also altered their bedroom environment to optimise sleep. Diet, exercise, alcohol and nicotine consumption were investigated minimally from a sleep hygiene perspective. Given that shift workers are engaging in practices in-line with current fatigue-management strategies, but contrary to sleep hygiene recommendations, further research is required. Specifically, assessment of the applicability of current sleep hygiene guidelines to shift workers (particularly caffeine and napping recommendations) is required, in addition to the development of shift work-specific sleep hygiene guidelines and interventions for this sleep-vulnerable population.
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15
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Pichard LE, Simonelli G, Schwartz L, Balkin TJ, Hursh S. Precision Medicine for Sleep Loss and Fatigue Management. Sleep Med Clin 2019; 14:399-406. [PMID: 31375208 DOI: 10.1016/j.jsmc.2019.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sleep loss is a widespread phenomenon and a public health threat. Sleep disorders, medical conditions, lifestyles, and occupational factors all contribute to insufficient sleep. Regardless of the underlying cause, insufficient sleep has well-defined consequences and the severity of said consequences partially influenced by individual characteristics. It is here where precision medicine needs to understand and define sleep insufficiency in hopes for personalizing medical approach to improve patient outcomes. Following a discussion on causes and consequences of sleep loss, this article discusses tools for assessing sleep sufficiency, mitigating strategies to sleep loss, and sleep loss in the context of fatigue management.
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Affiliation(s)
- Luis E Pichard
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
| | - Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Lindsay Schwartz
- Institutes for Behavior Resources, Inc, 2104 Maryland Avenue, Baltimore, MD 21218, USA
| | - Thomas J Balkin
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Steven Hursh
- Institutes for Behavior Resources, Inc, 2104 Maryland Avenue, Baltimore, MD 21218, USA
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16
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Cervilla O, Miró E, Martínez MP, Sánchez AI, Sabio JM, Prados G. Sleep quality and clinical and psychological manifestations in women with mild systemic lupus erythematosus activity compared to women with fibromyalgia: A preliminary study. Mod Rheumatol 2019; 30:1016-1024. [DOI: 10.1080/14397595.2019.1679973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Oscar Cervilla
- Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain
| | - Elena Miró
- Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - María Pilar Martínez
- Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - Ana Isabel Sánchez
- Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - José Mario Sabio
- Department of Internal Medicine, Hospital Universitario Virgen de las Nieves, Systemic Autoimmune Diseases Unit, Granada, Spain
| | - Germán Prados
- Department of Nursing, Health Science Faculty, University of Granada, Granada, Spain
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17
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Türkoğlu G, Selvi Y. The relationship between chronotype, sleep disturbance, severity of fibromyalgia, and quality of life in patients with fibromyalgia. Chronobiol Int 2019; 37:68-81. [DOI: 10.1080/07420528.2019.1684314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Gözde Türkoğlu
- Department of Physical Medicine and Rehabilitation, Konya Training and Research Hospital, Konya, Turkey
| | - Yavuz Selvi
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
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18
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Lazaridou A, Koulouris A, Devine JK, Haack M, Jamison RN, Edwards RR, Schreiber KL. Impact of daily yoga-based exercise on pain, catastrophizing, and sleep amongst individuals with fibromyalgia. J Pain Res 2019; 12:2915-2923. [PMID: 31802932 PMCID: PMC6802732 DOI: 10.2147/jpr.s210653] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 07/09/2019] [Indexed: 12/27/2022] Open
Abstract
Background Fibromyalgia (FM) is a chronic widespread pain disorder characterized by negative affect, sleep disturbance, and fatigue. This uncontrolled pilot study investigated the efficacy of daily yoga-based exercise to improve FM symptoms and explored baseline phenotypic characteristics associated with the greatest benefit. Methods FM patients (n=46, with 36 completers) reported psychosocial functioning and a range of FM symptoms using validated instruments before and after participation in Satyananda yoga, which included weekly in-person pain-tailored group classes for 6 weeks and daily home yoga video practice. Results Changes in FM symptoms from pre- to post-yoga were variable amongst participants. Group means for pain decreased, as reported by average daily diary and Brief Pain Inventory, with greater home practice minutes associated with a greater decrease in pain. Average daily ratings of sleep and fatigue improved. Pain catastrophizing was decreased overall, with greater change correlated to a decrease in FM symptoms. We did not observe any group mean changes in actigraphy sleep efficiency, Patient-Reported Outcomes Measurement Information System-anxiety and the Revised Fibromyalgia Impact Questionnaire. Multilevel Modeling analysis revealed a significant interaction between anxiety and catastrophizing for end-study sleep efficiency, fatigue, and pain, such that patients with higher baseline catastrophizing and lower baseline anxiety reported less pain and fatigue, and higher sleep efficiency after the sixth week of yoga practice. Conclusion This pilot study suggests that yoga may reduce pain and catastrophizing, as well as improve sleep, but these changes were modest across study participants. Greater uptake of home yoga practice as well as a phenotype of higher baseline catastrophizing combined with lower baseline anxiety were associated with greater impact. Future randomized, controlled trials comparing different types of yoga or exercise will allow determination of the most effective treatments for FM and allow closer targeting to the patients who will benefit most from them.
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Affiliation(s)
- Asimina Lazaridou
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA
| | - Alexandra Koulouris
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA
| | - Jaime K Devine
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Monika Haack
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Robert N Jamison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA
| | - Kristin L Schreiber
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA
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19
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Correa-Rodríguez M, Mansouri-Yachou JE, Casas-Barragán A, Molina F, Rueda-Medina B, Aguilar-Ferrandiz ME. The Association of Body Mass Index and Body Composition with Pain, Disease Activity, Fatigue, Sleep and Anxiety in Women with Fibromyalgia. Nutrients 2019; 11:E1193. [PMID: 31137906 PMCID: PMC6566359 DOI: 10.3390/nu11051193] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/14/2019] [Accepted: 05/22/2019] [Indexed: 12/26/2022] Open
Abstract
The link between fibromyalgia syndrome (FMS) and obesity has not been thoroughly investigated. The purpose of this study was to examine the relationships among body mass index (BMI) and body composition parameters, including fat mass, fat mass percentage, and visceral fat, as well as FMS features, such as tender point count (TPC), pain, disease activity, fatigue, sleep quality, and anxiety, in a population of FMS women and healthy controls. A total of seventy-three women with FMS and seventy-three healthy controls, matched on weight, were included in this cross-sectional study. We used a body composition analyzer to measure fat mass, fat mass percentage, and visceral fat. Tender point count (TPC) was measured by algometry pressure. The disease severity was measured with the Fibromyalgia Impact Questionnaire (FIQ-R) and self-reported global pain was evaluated with the visual analog scale (VAS). To measure the quality of sleep, fatigue, and anxiety we used the Pittsburgh Sleep Quality Questionnaire (PSQI), the Spanish version of the multidimensional fatigue inventory (MFI), and the Beck Anxiety Inventory (BAI), respectively. Of the women in this study, 38.4% and 31.5% were overweight and obese, respectively. Significant differences in FIQ-R.1 (16.82 ± 6.86 vs. 20.66 ± 4.71, p = 0.030), FIQ-R.3 (35.20 ± 89.02 vs. 40.33 ± 5.60, p = 0.033), and FIQ-R total score (63.87 ± 19.12 vs. 75.94 ± 12.25, p = 0.017) among normal-weight and overweight FMS were observed. Linear analysis regression revealed significant associations between FIQ-R.2 (β(95% CI)= 0.336, (0.027, 0.645), p = 0.034), FIQ-R.3 (β(95% CI)= 0.235, (0.017, 0.453), p = 0.035), and FIQ-R total score (β(95% CI)= 0.110, (0.010, 0.209), p = 0.032) and BMI in FMS women after adjusting for age and menopause status. Associations between sleep latency and fat mass percentage in FMS women (β(95% CI)= 1.910, (0.078, 3.742), p = 0.041) and sleep quality and visceral fat in healthy women (β(95% CI)= 2.614, (2.192, 3.036), p = 0.008) adjusted for covariates were also reported. The higher BMI values are associated with poor FIQ-R scores and overweight and obese women with FMS have higher symptom severity. The promotion of an optimal BMI might contribute to ameliorate some of the FMS symptoms.
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Affiliation(s)
- María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria Granada (IBS Granada), 18016 Granada, Spain.
| | - Jamal El Mansouri-Yachou
- Department of Physical Therapy, Faculty of Health Science, PhD student of the Biomedicine program of the University of Granada (UGR), 18016 Granada, Spain.
| | - Antonio Casas-Barragán
- Department of Physical Therapy, Faculty of Health Science, PhD student of the Biomedicine program of the University of Granada (UGR), 18016 Granada, Spain.
| | - Francisco Molina
- Department of Health Science, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain.
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Instituto de Investigación Biosanitaria Granada (IBS Granada), 18016 Granada, Spain.
| | - María Encarnación Aguilar-Ferrandiz
- Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), Instituto de Investigación Biosanitaria Granada (IBS. Granada), 18016 Granada, Spain.
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20
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Resistance Training Improves Quality of Life and Associated Factors in Patients With Fibromyalgia Syndrome. PM R 2019; 11:703-709. [DOI: 10.1016/j.pmrj.2018.09.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 02/05/2023]
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21
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Shaver JL, Iacovides S. Sleep in Women with Chronic Pain and Autoimmune Conditions: A Narrative Review. Sleep Med Clin 2018; 13:375-394. [PMID: 30098754 DOI: 10.1016/j.jsmc.2018.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic pain and sleep disturbances are intricately intertwined. This narrative review provides comments on observations related to pain, stress-immunity, and sleep. Sleep evidence is reviewed from studies of select conditions involving pain (ie, functional somatic syndromes and autoimmune) that are predominant in women. Chronic pain and poor sleep encompass persistent stress-immune activation with systemic inflammation, cellular oxidative stress, and sick behavior indicators that increase morbidity and threaten quality of life. In painful conditions, sleep impairments are nearly ubiquitous, and exaggerated combined effects should not be underestimated or ignored, nor should crucial implications for clinical practice and research.
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Affiliation(s)
- Joan L Shaver
- Biobehavioral Health Science Division, University of Arizona College of Nursing, 1305 North Martin Avenue, Tucson, AZ 85721, USA.
| | - Stella Iacovides
- Faculty of Health Sciences, Brain Function Research Group, School of Physiology, University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa
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22
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Borges-Cosic M, Aparicio VA, Estévez-López F, Soriano-Maldonado A, Acosta-Manzano P, Gavilán-Carrera B, Delgado-Fernández M, Geenen R, Segura-Jiménez V. Sedentary time, physical activity, and sleep quality in fibromyalgia: The al-Ándalus project. Scand J Med Sci Sports 2018; 29:266-274. [DOI: 10.1111/sms.13318] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/25/2018] [Accepted: 10/03/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
| | - Virginia A. Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology, Biomedical Research Center, Sport and Health Research Centre; University of Granada; Granada Spain
| | - Fernando Estévez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
- Institute of Nursing and Health Research, School of Health Sciences; Ulster University; Northern Ireland UK
- Department of Psychology, Faculty of Social and Behavioral Sciences; Utrecht University; Utrecht The Netherlands
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences; University of Almería; Almería Spain
- SPORT Research Group (CTS-1024), CERNEP Research Center; University of Almería; Almería Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sport, Faculty of Sport Sciences; University of Granada; Granada Spain
| | - Rinie Geenen
- Department of Psychology, Faculty of Social and Behavioral Sciences; Utrecht University; Utrecht The Netherlands
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences; University of Cádiz; Cádiz Spain
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23
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Yolanda Castaño M, Garrido M, Delgado-Adámez J, Martillanes S, Gómez M, Rodríguez AB. Oral melatonin administration improves the objective and subjective sleep quality, increases 6-sulfatoxymelatonin levels and total antioxidant capacity in patients with fibromyalgia. J Appl Biomed 2018. [DOI: 10.1016/j.jab.2018.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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De Roa P, Paris P, Poindessous JL, Maillet O, Héron A. Subjective Experiences and Sensitivities in Women with Fibromyalgia: A Quantitative and Comparative Study. Pain Res Manag 2018; 2018:8269564. [PMID: 29808107 PMCID: PMC5901832 DOI: 10.1155/2018/8269564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/23/2018] [Accepted: 02/28/2018] [Indexed: 01/03/2023]
Abstract
Fibromyalgia is a chronic widespread pain syndrome associated with chronic fatigue. Its pathogenesis is not clearly understood. This study presents subjective experiences and sensitivities reported by fibromyalgia patients, which should be considered in primary care to avoid medical nomadism, as well as stigmatization of the patients. The prevalence of significant characteristics was compared with others patients consulting at the same pain unit who suffer from rebel and disabling form of chronic migraine. Psychometric tests were anonymously completed by 78 patients of the Pain Unit (44 fibromyalgia patients and 34 migraine patients). Tests evaluated pain (Visual Analog scale), childhood traumas (Childhood Trauma Questionnaire), lack of parental affection, stressful life events (Holmes and Rahe Scale), anxiety and depression (Hospital Anxiety and Depression Scale), perceived hypersensitivity to 10 stimuli, and hyperactivity before illness. However, pain scores were comparable in the two groups, and the prevalence was significantly higher in fibromyalgia patients than in migraine patients for anxiety (81.8% versus 51.5%) and depression (57.1% versus 8.8%). Childhood physical abuses were more frequently reported in fibromyalgia than in migraine cases (25% versus 3%). Similarly, the feeling of lack of parental affection, subjective hypersensitivity to stress and stimuli (cold, moisture, heat, full moon, and flavors) or hyperactivity (ergomania), appeared as prominent features of fibromyalgia patients. Fibromyalgia patients considered themselves as being hypersensitive (mentally and physically) compared to migraine patients. They also have higher depression levels. Beyond somatic symptoms, precociously taking account of psychosocial and behavioral strategies would highly improve treatment efficiency of the fibromyalgia syndrome.
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Affiliation(s)
- P. De Roa
- Pain Unit, Dreux Hospital, GHT28, France
| | - P. Paris
- Department of Mental Health, Dreux Hospital, GHT28, France
| | - J. L. Poindessous
- Center of Treatment and Pain Evaluation, Ambroise Paré Hospital, Paris, France
| | - O. Maillet
- Clinical Research Unit URC28, Dreux Hospital, GHT28, France
| | - A. Héron
- Clinical Research Unit URC28, Dreux Hospital, GHT28, France
- Department of Human Physiology, Paris Descartes University, Paris, France
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25
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Andrade A, Vilarino GT, Sieczkowska SM, Coimbra DR, Bevilacqua GG, Steffens RDAK. The relationship between sleep quality and fibromyalgia symptoms. J Health Psychol 2018; 25:1176-1186. [DOI: 10.1177/1359105317751615] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study investigated the relationship between sleep quality and fibromyalgia symptoms in 326 patients. The Pittsburgh Sleep Quality Index was used to assess the presence of sleep disorders. Multivariate analysis of variance was performed to determine the influence of fibromyalgia symptoms on sleep quality. The prevalence of sleep disorders was 92.9 percent. Patients reported generalized pain (88.3%), memory failure (78.5%), moodiness (59%), excessive anxiety (77.5%), and concentration difficulties (69.1%). Patients with more symptoms reported poor sleep quality ( p < .05; d = .74), and the total Pittsburgh Sleep Quality Index score correlated with the number of symptoms ( p < .01). Sleep quality has an important association with fibromyalgia symptoms.
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Abstract
OBJECTIVE The study aimed to investigate the effect of an 8-wk structured strength training program on pain and sleep quality in patients with fibromyalgia. DESIGN Fifty-two patients with fibromyalgia were evaluated; 31 submitted to strength training and 21 comprised the control group. The instruments used were the Fibromyalgia Impact Questionnaire and The Pittsburgh Sleep Quality Index. The questionnaires were applied before the first training session, at 12 sessions, and after 24 sessions. Descriptive statistics (mean, SD, and frequency) and inferential tests were used. RESULTS After 8 wks of intervention, significant differences were found between groups in subjective quality of sleep (P = 0.03), sleep disturbance (P = 0.02), daytime dysfunction (P = 0.04), and total sleep score (P < 0.01). The correlation analysis using Spearman's test indicated a positive relationship between the variables of pain intensity and sleep quality (P < 0.01); when pain intensity increased in patients with fibromyalgia, sleep quality worsened. CONCLUSIONS Strength training is safe and effective in treating people with fibromyalgia, and a significant decrease in sleep disturbances occurs after 8 wks of intervention.
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Davis F, Gostine M, Roberts BA, Risko R, Cappelleri JC, Sadosky A. Interpreting the Effectiveness of Opioids and Pregabalin for Pain Severity, Pain Interference, and Fatigue in Fibromyalgia Patients. Pain Pract 2017; 18:611-624. [PMID: 29064627 DOI: 10.1111/papr.12651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/27/2017] [Accepted: 10/17/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of opioids and/or pregabalin on patient-reported outcomes among fibromyalgia (FM) patients based on levels of improvement. METHODS A total of 1,421 FM patients were identified, with 3,082 observational periods of opioids with or without pregabalin use between April 2008 and February 2015. Patients were categorized by opioids, and pregabalin with and without opioids; opioids were designated by morphine equivalent dose (MED) of ≤ 20 (low MED), > 20 to < 100 (moderate MED), ≥ 100 (high MED), and pregabalin doses of ≤ 150 mg, 151 to 300 mg, and 301 to 450 mg. Proportions of patients meeting clinically relevant thresholds of ≥ 30% and ≥ 50% improvement for pain interference (ability to enjoy life; activity; mood; relationships; sleep), pain severity, and fatigue were compared among treatments, and area under the curve (AUC) for improvement and worsening of effects was determined, enabling ranking of treatments. Further analysis compared pregabalin doses. RESULTS Pregabalin without opioids resulted in the highest proportions of patients with ≥ 30% improvement on all pain items and pain interference with "ability to enjoy life," "activity" "mood," and "sleep." For the ≥ 50% threshold, pregabalin alone was highest for all pain interference items and for "average pain" and "worst pain." Pregabalin was consistently lowest across thresholds for fatigue, but showed better results combined with moderate MED opioids. Pregabalin doses recommended for treatment of FM (151 to 450 mg) generally resulted in the highest proportion of patients achieving thresholds relative to opioids. The AUC results were consistent with thresholds; pregabalin without opioids resulted in the greatest benefits with regard to improvement, with the highest ranking for overall improvement and overall effects. CONCLUSION Pregabalin without opioids provided the most favorable outcomes overall based on ≥ 30% and ≥ 50% improvement thresholds and AUC, with support for moderate MED opioids + pregabalin in patients suffering from fatigue. While most patients took less than recommended pregabalin doses, higher doses may lead to improved outcomes.
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Affiliation(s)
- Fred Davis
- ProCare Systems, Inc., Grand Rapids, Michigan, U.S.A
| | - Mark Gostine
- Michigan Pain Consultants, Grand Rapids, Michigan, U.S.A
| | | | - Rebecca Risko
- ProCare Systems, Inc., Grand Rapids, Michigan, U.S.A
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Efficacy of Combined Cognitive-Behavioral Therapy for Insomnia and Pain in Patients with Fibromyalgia: A Randomized Controlled Trial. COGNITIVE THERAPY AND RESEARCH 2017. [DOI: 10.1007/s10608-017-9875-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Fibromyalgia (FMS) is a complex clinical syndrome that includes many symptoms beyond chronic pain. The studies that have addressed brain morphometry in FMS have had very heterogeneous results. Thus, the question of which specific FMS symptoms and clinical features-pain, but also psychological distress, sleep-related problems, health status, and medication intake-impact on brain morphometry remains open. Here, we wanted to determine if brain changes in FMS are "symptom-related" more than "diagnostic-related". We performed an observational study of 46 premenopausal women (23 FMS patients and 23 age-matched healthy participants). Magnetic resonance images were analyzed using voxel-based morphometry and subcortical segmentation. We used multiple regression models to assess the associations between total and local brain volumes and FMS clinical characteristics. Furthermore, we calculated associations between subcortical structures' shapes and volumes and FMS clinical characteristics. Larger psychological distress, anxiety, and sleepiness, and higher analgesic consumption accounted for 38 % of FMS patients' smaller total gray matter volume (GMV). For both groups, local decrements of GMV in the medial orbitofrontal cortex were associated to larger psychological distress. Local increases of GMV were positively related to pain scores (superior frontal gyrus), psychological distress (cerebellum), anxiety (medial orbitofrontal cortex), and sleepiness (frontal superior medial cortex). FMS clinical characteristics were also associated to deformations in subcortical structures and volumes changes. This study reveals that total and local GMV changes in FMS go beyond the traditional "pain matrix" alterations. We demonstrated that brain morphology is altered by pain, but also by clinical characteristics that define the FMS experience.
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Heymann RE, Paiva ES, Martinez JE, Helfenstein M, Rezende MC, Provenza JR, Ranzolin A, Assis MRD, Feldman DP, Ribeiro LS, Souza EJR. New guidelines for the diagnosis of fibromyalgia. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57 Suppl 2:467-476. [PMID: 28800969 DOI: 10.1016/j.rbre.2017.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To establish guidelines based on scientific evidence for the diagnosis of fibromyalgia. MATERIAL AND METHODS Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the Patient, Intervention or Indicator, Comparison and Outcome (P.I.C.O.), with searches in the main, primary databases of scientific information. After defining the potential studies to support the recommendations, they were graded according to evidence and degree of recommendation.
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Affiliation(s)
- Roberto E Heymann
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Estado de São Paulo, São Paulo, SP, Brazil.
| | - Eduardo S Paiva
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - José Eduardo Martinez
- Sociedade Brasileira de Reumatologia, Brazil; Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brazil
| | - Milton Helfenstein
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Estado de São Paulo, São Paulo, SP, Brazil
| | - Marcelo C Rezende
- Sociedade Brasileira de Reumatologia, Brazil; Santa Casa de Campo Grande, Campo Grande, MS, Brazil
| | - Jose Roberto Provenza
- Sociedade Brasileira de Reumatologia, Brazil; Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil
| | - Aline Ranzolin
- Sociedade Brasileira de Reumatologia, Brazil; Hospital das Clínicas de Pernambuco, Recife, PE, Brazil
| | - Marcos Renato de Assis
- Sociedade Brasileira de Reumatologia, Brazil; Faculdade de Medicina de Marília, Marília, SP, Brazil
| | - Daniel P Feldman
- Sociedade Brasileira de Reumatologia, Brazil; Universidade Federal do Estado de São Paulo, São Paulo, SP, Brazil
| | - Luiz Severiano Ribeiro
- Sociedade Brasileira de Reumatologia, Brazil; Hospital do Servidor Público de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eduardo J R Souza
- Sociedade Brasileira de Reumatologia, Brazil; Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
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Oliveras I, Losilla JM, Vives J. Methodological quality is underrated in systematic reviews and meta-analyses in health psychology. J Clin Epidemiol 2017; 86:59-70. [DOI: 10.1016/j.jclinepi.2017.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 12/09/2016] [Accepted: 05/02/2017] [Indexed: 01/09/2023]
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Wu YL, Chang LY, Lee HC, Fang SC, Tsai PS. Sleep disturbances in fibromyalgia: A meta-analysis of case-control studies. J Psychosom Res 2017; 96:89-97. [PMID: 28545798 DOI: 10.1016/j.jpsychores.2017.03.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 03/19/2017] [Accepted: 03/22/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Sleep disturbances are common in fibromyalgia, but the features of sleep disturbances are not well understood. We performed a systematic review and meta-analysis of case-control studies to compare the sleep outcomes of individuals with fibromyalgia and healthy controls. METHODS We systematically searched eight databases (PubMed, Ovid MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Airiti Library and Wanfang Data) for articles published before April 2016. RESULTS Twenty-five case-controlled studies and a total of 2086 participants were included in the meta-analysis. Sleep was assessed using polysomnography and the Pittsburgh Sleep Quality Index. When sleep was assessed using polysomnography (19 studies), significant differences were observed in wake time after sleep onset (g=0.81, 95% confidence interval [CI] 0.21-1.41), total sleep time (g=-0.78, 95% CI=-1.34 to -0.15), sleep efficiency (g=-0.78, 95% CI=-1.23 to -0.32), percentage of stage 1 sleep (g=0.55, 95% CI=0.15-0.95), and percentage of slow-wave sleep (g=-0.66, 95% CI=-1.21 to -0.12) between participants with fibromyalgia and healthy controls. When sleep was assessed using the Pittsburgh Sleep Quality Index (7 studies), significant differences were observed in global scores (g=2.19, 95% CI 1.58-2.79), sleep onset latency (g=1.75, 95% CI 0.80-2.70), and sleep efficiency (g=-1.08, 95% CI -1.65 to -0.51) between participants with fibromyalgia and healthy controls. CONCLUSION Individuals with fibromyalgia experience lower sleep quality and sleep efficiency; longer wake time after sleep onset, short sleep duration, and light sleep when objectively assessed and more difficulty in initiating sleep when subjectively assessed. Sleep difficulties in fibromyalgia appear to be more when reported subjectively than when assessed objectively. COMPLIANCE WITH ETHICAL STANDARDS This study received no funding from any source. All authors declare that they have no conflict of interest. This article does not contain any studies with human participants performed by any of the authors.
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Affiliation(s)
- Yu-Lin Wu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ling-Yin Chang
- Division of Child Health Research, Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Su-Chen Fang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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Heymann RE, Paiva ES, Martinez JE, Helfenstein M, Rezende MC, Provenza JR, Ranzolin A, Assis MRD, Feldman DP, Ribeiro LS, Souza EJ. Novas diretrizes para o diagnóstico da fibromialgia. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Decrease of Serum IGF-1 Level is Not Associated With Obstructive Sleep Apnea in Fibromyalgia Patients. Arch Rheumatol 2016; 32:105-111. [PMID: 30375572 DOI: 10.5606/archrheumatol.2017.5926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/01/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the relationship of serum insulin-like growth factor 1 (IGF-1) level with obstructive sleep apnea, the Pittsburgh sleep quality index (PSQI), age, body mass index, and fibromyalgia impact questionnaire (FIQ) in fibromyalgia syndrome (FMS) patients. Patients and methods A total of 105 female patients (mean age 41.8±9.0 years; range 26 to 55 years) with fibromyalgia (FMS group) who were diagnosed according to 2010 American College of Rheumatology criteria, and 51 female patients (mean age 39.9±10.8 years; range 24 to 54 years) with mechanical low back pain (MLBP) (control group) were included in the study. Age, smoking, educational status, tender point number, body mass index, duration of disease, FIQ, PSQI, and polysomnographic assessment of both FMS and control groups were recorded. Results Sleep disorder was detected in 88 patients in FMS group and 15 patients in control group (p<0.05). The PSQI score was higher in the FMS group compared to the control group (9.9±4.6 vs. 5.7±3.5). The FIQ score was higher in the FMS group compared to the control group (53.4±17.4 vs. 26.4±13.9; p<0.05). The serum IGF-1 level of FMS group was significantly lower than that of the control group (140.6±49.5 ng/mL vs. 177.2±58.5 ng/mL; p<0.05). In the FMS group, an examination of the correlation between serum IGF-1 level with the age, body mass index, obstructive sleep apnea syndrome, FIQ, and PSQI revealed a negative correlation between serum IGF-1 with the age and PSQI. The obstructive sleep apnea syndrome ratios of study groups were comparable with regard to the frequencies of mild, moderate, and severe obstructive sleep apnea syndrome. Conclusion In FMS patients, serum IGF-1 levels may decrease due to age and PSQI; however, this may not be related to the severity of obstructive sleep apnea.
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Patel A, Hasak S, Cassell B, Ciorba MA, Vivio EE, Kumar M, Gyawali CP, Sayuk GS. Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome. Aliment Pharmacol Ther 2016; 44:246-58. [PMID: 27240555 PMCID: PMC5020700 DOI: 10.1111/apt.13677] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 01/08/2016] [Accepted: 05/06/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sleep disturbances are common, and perhaps are even more prevalent in irritable bowel syndrome (IBS). AIMS To determine the effect of measured sleep on IBS symptoms the following day, IBS-specific quality of life (IBS-QOL) and non-GI pain symptoms. METHODS IBS patients' sleep patterns were compared to healthy individuals via wrist-mounted actigraphy over 7 days. Daily bowel pain logs (severity, distress; 10-point Likert) stool pattern (Bristol scale) and supporting symptoms (e.g. bloating, urgency; 5-point Likert) were kept. Validated measures, including the GI Symptom Rating Scale-IBS, Visceral Sensitivity Index, Pittsburgh Sleep Quality Index and the IBS-Quality of Life were collected. Mediation analysis explored the relationship between sleep, mood and bowel symptoms. RESULTS Fifty subjects (38.6 ± 1.0 years old, 44 female; 24 IBS and 26 healthy controls) completed sleep monitoring. IBS patients slept more hours per day (7.7 ± 0.2 vs. 7.1 ± 0.1, P = 0.008), but felt less well-rested. IBS patients demonstrated more waking episodes during sleep (waking episodes; 12.1 vs. 9.3, P < 0.001). Waking episodes predicted worse abdominal pain (P ≤ 0.01) and GI distress (P < 0.001), but not bowel pattern or accessory IBS symptoms (P > 0.3 for each). Waking episodes negatively correlated with general- and IBS-specific QOL in IBS (r = -0.58 and -0.52, P < 0.001 for each). Disturbed sleep effects on abdominal pain were partially explained by mood as an intermediate. CONCLUSIONS Sleep disturbances are more common in irritable bowel syndrome, and correlate with IBS-related pain, distress and poorer irritable bowel syndrome-related quality of life. Disturbed sleep effects extend beyond the bowel, leading to worse mood and greater somatic pain in patients with the irritable bowel syndrome.
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Affiliation(s)
- Ami Patel
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Stephen Hasak
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Benjamin Cassell
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Matthew A. Ciorba
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Emily E. Vivio
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Mrudula Kumar
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - C. Prakash Gyawali
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Gregory S. Sayuk
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA,Gastroenterology Section, John Cochran Veterans Affairs Medical Center, St. Louis, Missouri, USA
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Shi H, Yuan C, Dai Z, Ma H, Sheng L. Gray matter abnormalities associated with fibromyalgia: A meta-analysis of voxel-based morphometric studies. Semin Arthritis Rheum 2016; 46:330-337. [PMID: 27989500 DOI: 10.1016/j.semarthrit.2016.06.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 04/28/2016] [Accepted: 06/06/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Studies employing voxel-based morphometry (VBM) have reported inconsistent findings on the association of gray matter (GM) abnormalities with fibromyalgia. The aim of the present study is to identify the most prominent and replicable GM areas that involved in fibromyalgia. METHODS A systematic search of the PubMed database from January 2000 to September 2015 was performed to identify eligible whole-brain VBM studies. Comprehensive meta-analyses to investigate regional GM abnormalities in fibromyalgia were conducted with the Seed-based d Mapping software package. RESULTS Seven studies, reporting nine comparisons and including a grand total of 180 fibromyalgia patients and 126 healthy controls, were included in the meta-analyses. In fibromyalgia patients compared with healthy controls, regional GM decreases were consistently found in the bilateral anterior cingulate/paracingulate cortex/medial prefrontal cortex, the bilateral posterior cingulate/paracingulate cortex, the left parahippocampal gyrus/fusiform cortex, and the right parahippocampal gyrus/hippocampus. Regional GM increases were consistently found in the left cerebellum. Meta-regression demonstrated that age was correlated with GM anomalies in fibromyalgia patients. CONCLUSIONS The current meta-analysis identified a characteristic pattern of GM alterations within the medial pain system, default mode network, and cerebro-cerebellar circuits, which further supports the concept that fibromyalgia is a symptom complex involving brain areas beyond those implicated in chronic pain.
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Affiliation(s)
- HaiCun Shi
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, P.R. China
| | - CongHu Yuan
- Department of Anesthesia and Pain Management, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, P.R. China
| | - ZhenYu Dai
- Department of Radiology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, P.R. China
| | - HaiRong Ma
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, 215300, Chaoyang Rd 189#, Kunshan, P.R. China
| | - LiQin Sheng
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, 215300, Chaoyang Rd 189#, Kunshan, P.R. China.
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Sleep disturbances in fibromyalgia syndrome: the role of clinical and polysomnographic variables explaining poor sleep quality in patients. Sleep Med 2015; 16:917-25. [DOI: 10.1016/j.sleep.2015.03.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/10/2015] [Accepted: 03/04/2015] [Indexed: 11/21/2022]
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Hamilton NA. Sleep and fibromyalgia: it is time to think big. Sleep Med 2015; 16:908-9. [DOI: 10.1016/j.sleep.2015.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/01/2015] [Indexed: 10/23/2022]
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