Comparison of sleep structure and psychometric profiles in patients with fibromyalgia, osteoarthritis and healthy controls

© 2017 European Sleep Research Society While research indicates that both the macro- and microstructure of sleep may be altered in fibromyalgia syndrome, few studies have controlled for symptom duration or included pain-control participants (i.e. patients with chronic pain and sleep disturbance not associated with fibromyalgia syndrome). A frequently reported alteration found in the sleep microstructure of patients with fibromyalgia syndrome is the alpha-delta sleep anomaly. Although alpha waves have been observed during N3 sleep in healthy individuals, it has been proposed that there is an increase in alpha wave activity during slow-wave sleep in fibromyalgia syndrome. Originally considered a possible neurological contribution to fibromyalgia syndrome, whether the alpha-delta sleep anomaly is fundamental to the development of fibromyalgia syndrome, or results mainly from the pain experience remains unknown. The present study was designed to compare sleep macro- and microstructure, and psychometric profiles, in three broadly age-matched groups of female participants: patients with fibromyalgia syndrome (n = 19); patients with osteoar thritis with sleep disturbance (n = 17); and healthy adults (n = 10). Patients with fibromyalgia syndrome met the American College of Rheumatology diagnostic criteria and were recruited within 6 months of diagnosis. Subjective sleep quality was significantly lowest, and levels of anxiety and depressive symptoms were significantly highest for patients with fibromyalgia syndrome. However, the groups showed no significant differences in polysomnographic measures of total sleep time, sleep latency and total wake after sleep onset. Levels of alpha-delta sleep were statistically similar in both clinical (fibromyalgia syndrome and osteoarthritis) groups, indicating that it is not a specific abnormality of fibromyalgia syndrome. Overall, subjective measurements of anxiety, depression, fatigue and sleep quality better discriminated between the three groups than did objective measurements of sleep variables

chronic urticaria is usually associated with fibromyalgia syndrome

Although the pathophysiology of chronic urticaria is not fully understood, it is possible that dysfunctioning of peripheral cutaneous nerve fibres may be involved. It has also been suggested that fibromyalgia syndrome, a multi-symptomatic chronic pain condition, may be associated with alterations and dysfunctioning of peripheral cutaneous nerve fibres. The aim of this study was to determine whether patients with chronic urticaria are also affected by fibromyalgia syndrome. A total of 126 patients with chronic urticaria were investigated for fibromyalgia syndrome. An unexpectedly high proportion (over 70%) had fibromyalgia syndrome. The corresponding proportion for 50 control dermatological patients was 16%, which is higher than previously published data for the Italian general population (2.2%). It is possible that dysfunctional cutaneous nerve fibres of patients with fibromyalgia syndrome may release neuropeptides, which, in turn, may induce dermal microvessel dilatation and plasma extravasation. Furthermore, some neuropeptides may favour mast cell degranulation, which stimulates nerve endings, thus providing positive feedback. Chronic urticaria may thus be viewed in many patients, as a consequence of fibromyalgia syndrome. Speculatively, skin neuropathy (fibromyalgia syndrome) may trigger neurogenic skin inflammation (chronic urticaria)

Perceptions about the sexuality of women with fibromyalgia syndrome: a phenomenological study

Aims: The aim of this study was to explore and understand the perceptions and experiences of women with fibromyalgia syndrome regarding their sexuality. Background: Fibromyalgia syndrome is a chronic pathology, which compromises a woman’s physical, mental and emotional health. Although concerns related to sexuality are commonly reported, research has tended to focus on the physical symptoms. Design: An interpretive qualitative research methodology using Gadamer’s philosophical hermeneutics was carried out. Methods: This qualitative study explores the sexuality of women with fibromyalgia syndrome. A focus group and semi-structured interviews were conducted with 13 women with fibromyalgia syndrome. Data were collected between April - June 2014. Participants were recruited until findings reached saturation. Findings: Three themes define the perception of sexuality for these women: (i) Physical impact: don’t touch, don’t look; (ii) Sexuality and identity: fighting against their loss; (iii) Impact on the relationship: sexuality as a way of connecting the couple. Conclusion: Despite limitations, sexuality is important for the identity and quality of life of women with fibromyalgia syndrome. Together with the physical symptomology, guilt, fear and a lack of understanding compromise the coping process. Women need the support of their partner, their socio-family environment and health professionals. Nurses can aid the successful adjustment to sexual problems related to fibromyalgia syndrome

Fibromyalgia syndrome: epidemiology, diagnosis and treatment

Fibromyalgia syndrome (FMS) profoundly impacts patients’ quality of life with its symptoms and clinical signs. Fibromyalgia syndrome impairs daily living activities, reduces work efficiency and raises health-related costs. Although the prevalence rates vary depending on geographical location and diagnostic criteria, it is a common disorder worldwide. Females have a higher prevalence of fibromyalgia syndrome, with varied rates, and there is an increase in prevalence rates with age. Although its etiopathogenesis has not been fully elucidated, various hypotheses have been proposed that central sensitization is at the core of the process. Fibromyalgia syndrome diagnostic approaches have advanced significantly over time, moving away from pain assessments alone and emphasizing multiple clinical signs of FMS. This condition has raised physicians’ and researchers’ awareness of non-pain symptoms. Considering the complicated etiopathogenesis of fibromyalgia syndrome, diverse pathways connected with symptoms, and multiple clinical presentations, it becomes clear that drug and non-drug treatments should be chosen in combination. © 2022 Termedia Publishing House Ltd.. All rights reserved

Perceptions about the sexuality of women with fibromyalgia syndrome: a phenomenological study

Aims: The aim of this study was to explore and understand the perceptions and experiences of women with fibromyalgia syndrome regarding their sexuality. Background: Fibromyalgia syndrome is a chronic pathology, which compromises a woman’s physical, mental and emotional health. Although concerns related to sexuality are commonly reported, research has tended to focus on the physical symptoms. Design: An interpretive qualitative research methodology using Gadamer’s philosophical hermeneutics was carried out. Methods: This qualitative study explores the sexuality of women with fibromyalgia syndrome. A focus group and semi-structured interviews were conducted with 13 women with fibromyalgia syndrome. Data were collected between April - June 2014. Participants were recruited until findings reached saturation. Findings: Three themes define the perception of sexuality for these women: (i) Physical impact: don’t touch, don’t look; (ii) Sexuality and identity: fighting against their loss; (iii) Impact on the relationship: sexuality as a way of connecting the couple. Conclusion: Despite limitations, sexuality is important for the identity and quality of life of women with fibromyalgia syndrome. Together with the physical symptomology, guilt, fear and a lack of understanding compromise the coping process. Women need the support of their partner, their socio-family environment and health professionals. Nurses can aid the successful adjustment to sexual problems related to fibromyalgia syndrome

Sleep Dysfunction in Fibromyalgia and Therapeutic Approach Options

Fibromyalgia, characterised by persistent pain, sleep disturbance, fatigue and cognitive dysfunction, is a central sensitivity syndrome that also involves abnormality in peripheral generators and in the hypothalamic pituitary adrenal axis. Heterogeneity of clinical expression of fibromyalgia with a multifactorial aetiology has made the development of effective therapeutic strategies challenging. Non-restorative sleep associated with poor sleep quality is a characteristic of fibromyalgia which is linked to symptom severity. A relationship between sleep disorder and central sensitization could be a possible factor involved in development, exacerbation and/or maintenance of fibromyalgia. Association between disordered sleep and the risk of fibromyalgia suggests that limiting sleep problems would reduce the incidence of the condition. Therapeutic approaches with treatments that consolidate or deepen sleep may be preferential to improve sleep in patients with fibromyalgia. Thus, disordered sleep appears fundamental to the pathophysiology of fibromyalgia and as such the risk of sleep disturbances needs to be proactively assessed and when identified in this patient group be actively managed to improve health outcomes for patients with fibromyalgia

Differentiation of Self, Perceived Stress, and Symptom Severity Among Patients with Fibromyalgia Syndrome

This article presents an empirical examination of the usefulness of Bowen family systems theory as a framework for understanding fibromyalgia syndrome. This cross-sectional Internet-based survey included 201 participants diagnosed with fibromyalgia syndrome. Results indicated that more severe symptoms of fibromyalgia syndrome are significantly correlated with higher levels of perceived stress, lower levels of differentiation of self, and higher levels of emotional cutoff. In addition, indicators of differentiation of self (i.e., emotional cutoff and emotional reactivity) were found to moderate the relationship between perceived stress and symptom severity, although these indicators did not account for large proportions of the observed variances in symptom severity. Implications for Bowen family systems theory and clinical practice and recommendations for future research are discussed

Demographic, clinical, and treatment characteristics of the juvenile primary fibromyalgia syndrome cohort enrolled in the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry.

BackgroundTo describe the demographic, clinical, and treatment characteristics of youth diagnosed with juvenile primary fibromyalgia syndrome (JPFS) who are seen in pediatric rheumatology clinics.MethodsInformation on demographics, symptoms, functioning, and treatments recommended and tried were obtained on patients with JPFS as part of a multi-site patient registry (the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry). Data were summarized using descriptive statistics. In a subset of patients completing registry follow-up visits, changes in symptoms, pain, and functioning were evaluated using growth modeling.ResultsOf the 201 patients with JPFS enrolled in the registry, most were Caucasian/White (85%), non-Hispanic (83%), and female (84%). Ages ranged from 9 to 20 years (M = 15.4 + 2.2). The most common symptoms reported were widespread musculoskeletal pain (91%), fatigue (84%), disordered sleep (82%), and headaches (68%). Pain intensity was rated as moderate to severe (M = 6.3 + 2.4/10). Scores on measures of functioning indicated mild to moderate impairment, with males observed to report significantly greater impairments. For the 37% of the initial cohort having follow-up data available, indicators of function and well-being were found to either worsen over time or remain relatively unchanged.ConclusionsThe symptoms of JPFS remained persistent and disabling for many patients treated by pediatric rheumatologists. Further study appears warranted to elucidate gender differences in the impact of JPFS symptoms. Work also is needed to identify accessible and effective outpatient treatment options for JPFS that can be routinely recommended or implemented by pediatric rheumatology providers

Is fibromyalgia the most common diagnosis amongst female out-patients?

Background: The objectives of this study were to determine the prevalence of fibromyalgia syndrome (FMS) among women coming to outpatient department.Methods: A total of 68,625 female patients were evaluated out of which 47,901 were in the inclusion criteria. The screening protocol included interview items that have been defined as components of FMS using the 1990 American College of Rheumatology (ACR) classification criteria. Data was entered in mx excel sheet and results were analyzed. The socio-demographic data was expressed in proportions.Results: Out of 47,901 female patients, about 40.7% of the patients were diagnosed to have fibromyalgia syndrome (FMS). Out of which the major group of patients belong to married, unskilled women aged between 40-60 years of age. Conclusions: Fibromyalgia syndrome is the commonest diagnosis among the female patients coming to orthopedic outpatient department