Sleep disturbances in fibromyalgia: A meta-analysis of case-control studies

Wu, Yu; Chang, Ling-Yin; Lee, Hsin Chien; Fang, Su-Chen; Tsai, Pei‐Shan

doi:10.1016/j.jpsychores.2017.03.011

Cited by 96 publications

(81 citation statements)

References 57 publications

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“…In this study, pain severity was positively associated with the number of PVT lapses. Our findings corroborated previous findings that patients with fibromyalgia who experience intense pain also have considerably poorer learning and memory performance (Wu et al., ), attention function and psychomotor processing speed (Galvez‐Sánchez, Reyes Del Paso, & Duschek, ; Park, Glass, Minear, & Crofford, ; Veldhuijzen et al., ) in cognitive domains compared with healthy individuals. However, we noted that pain severity was not associated with RT—a finding consistent with that of Coppieters et al.…”

Section: Discussionsupporting

confidence: 91%

“…These findings are based on the “lapse hypothesis” (Williams, Lubin, & Goodnow, ), which posits that an individual with sleep deprivation has considerably prolonged RT and increased frequency of omission and commission errors (Lim & Dinges, ); in other words, individuals with low SQ may have compromised ability to sustain their attention. Compared with healthy individuals, the patients with fibromyalgia who experienced sleep disturbance had lower SQ and SE, shorter sleep duration and longer WASO (Wu, Chang, Lee, Fang, & Tsai, ). Regarding sleep disturbance, low SQ (Gobin, Banks, Fins, & Tartar, ) was associated with impaired performance speed in complex cognitive tasks (C‐Ote & Moldofsky, ) and lower sustained attention (Gobin et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…The following variables were selected to account for potential confounders in the association between pain severity and cognitive performance according to previous studies (Ojeda et al., ; Wu et al., ). The covariates included age, body mass index (BMI), employment status (yes/no), duration since diagnosis (months), hypnotics, gabapentin, analgesics or antidepressants use, napping habits (yes/no) and exercise habits (yes/no).…”

Section: Methodsmentioning

confidence: 99%

“…Fibromyalgia syndrome is characterized by chronic widespread musculoskeletal pain combined with symptoms including fatigue, cognitive impairment and sleep disturbance (Clauw, ). Cognitive deficits such as impaired attention, longer reaction time (RT), working memory deficit, language‐related problems, and reduced organization and planning abilities are common complaints among patients with fibromyalgia (Dick, Verrier, Harker, & Rashiq, ; Duschek, Werner, Winkelmann, & Wankner, ; Tesio et al., ; Veldhuijzen, Sondaal, & Oosterman, ; Wu, Huang, Fang, Ko, & Tsai, ). A recent meta‐analysis of case–control studies showed that patients with fibromyalgia have impaired learning and memory, as well as impaired attention and psychomotor speed compared with healthy controls (Wu et al., ).…”

Section: Introductionmentioning

confidence: 99%

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Subjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia

Fang

Chen

et al. 2019

Journal of Sleep Research

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Pain severity and sleep are associated with cognitive performance in patients with fibromyalgia. This study examined whether sleep mediates the relationships of pain severity with psychomotor vigilance and attention in patients with fibromyalgia by analysing 80 patients with fibromyalgia. Cognitive performance, pain severity and sleep parameters were determined using the Psychomotor Vigilance Task, Brief Pain Inventory–Short Form and sleep diaries of seven consecutive nights, respectively. The patients’ demographic data were analysed for potential confounding factors. After adjustment for these confounders, a series of regression analyses was performed to examine the mediating role of sleep. The results indicated that higher pain severity was strongly associated with poorer sustained attention and lower sleep quality, the total effects of pain severity on psychomotor vigilance and attention were significant (c path: β = 0.23, p = 0.04), and pain severity was a significant sleep quality predictor (a path: β = −0.33, p < 0.01). When sleep quality was entered into the regression model (a × b path), the effects of pain severity on psychomotor vigilance and attention became non‐significant (c′ path: β = 0.15, p = 0.20) after adjustment of age, indicating a complete mediating effect of sleep quality in the pain severity–cognitive performance relationship. In conclusion, sleep quality mediates the pain severity–cognitive performance relationship: pain affects sleep quality, which in turn impairs sustained attention. Our findings provide further insight into the processes underlying the relationship between pain and poor cognitive function. Improved sleep quality may offset the detrimental effects of pain on sustained attention.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia

Fang

Chen

et al. 2019

Journal of Sleep Research

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“…A 2017 meta-analysis found significant differences in sleep efficiency (SE), a measure of total time spent in REM (Rapid Eye movement) sleep, number of arousals and sleep quality. 3 Prados et al in 2013 showed women with FM have less severe sleep disturbance than males, suggesting a gender difference. 4 Objectives: To identify the incidence of FM in a cohort referred to the respiratory department for diagnostic polysomnography (dPSG) at the Gold Coast University Hospital (GCUH), a tertiary referral centre in Australia.…”

mentioning

confidence: 98%

Thu0477 a Fibromyalgia Assessment Screening Tool on a Multidimensional Health Assessment Questionnaire (Mdhaq) Which Does Not Include a Self-Report Painful Joint Count (Painful Jc), Fast3njc, Recognizes Fibromyalgia Similarly to Other Fast3 Indices Which Include a Painful Jc

Pincus

Castrejón

2019

Poster Presentations

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BackgroundFibromyalgia (FM) generally is easily recognized, but a diagnosis may be difficult, particularly in patients with secondary FM who have other primary diagnoses. Criteria for FM initially were reported in 2000, and revised in 2011 and 2016, based entirely on a patient self-report questionnaire. However, FM criteria are not collected in most routine clinical care, as it is not feasible to use multiple patient questionnaires in busy clinical settings. MDHAQ/RAPID3 (multi-dimensional health assessment questionnaire/routine assessment of patient index data) has been found informative in all diseases in which it has been studied. Cumulative indices based on MDHAQ scales known as FAST3 (fibromyalgia assessment screening tool3) recognize FM at levels of agreement with revised FM criteria of >80% and correlations of >0.80, p<0.001). Pragmatic recognition of FM in non-rheumatic diseases based on MDHAQ may be possible, as most components of the MDHAQ (as well as the HAQ) appear generic rather than disease-specific. One component of MDHAQ/FAST indices, a self-report painful joint count (painful JC), is rheumatology-specific. Therefore, a FAST3-nJC (no painful JC) index was analyzed vs revised FM criteria as gold standards for possible use in non-rheumatology patients to recognize FM.ObjectivesTo analyze FAST3-nJC versus 2011 and 2016 FM criteria, and compared to other FAST3 indices which include a painful JC, to recognize FM.MethodsAll patients with all diagnoses complete an MDHAQ at all visits in routine care at one setting. The self-report questionnaire to recognize the 2011 and 2016 FM Criteria was added over a 6-month period to be completed by consecutive patients. The MDHAQ includes 0-10 scores for physical function, pain and patient global visual analog scales (VAS), compiled into 0-30 RAPID3, as well as a 0–10 fatigue VAS, 0–54 self-report painful joint count, and 0–60 symptom checklist. All MDHAQ scales were analyzed for agreement with FM Criteria according to receiver-operator-characteristic (ROC) curves for area under the curve (AUC). Optimal cut points for each measure were identified, based on specificity and sensitivity, to develop optimal cumulative indices for clues to FM versus the 2011 and 2016 Criteria as gold standards.ResultsAmong 502 patients with complete data, primary ICD-10 diagnoses were FM in 49, OA in 74, RA in 78, SLE 88 and other rheumatic diseases in 213. Primary or secondary FM was identified in 131 (26%) who met 2011 FM criteria, and 112 (22%) who met 2016 FM criteria. The 4 MDHAQ scales with the highest AUC vs FM Criteria (0.829-0.889) were symptom checklist, painful JC, fatigue, and pain. Three cumulative FAST3 measures were: FAST3-P with symptom checklist, painful JC and pain VAS; FAST3-F with symptom checklist, painful JC and fatigue VAS; FAST3nJC with symptom checklist, pain and fatigue VAS, but no painful JC. All FAST3 indices agreed with FM Criteria >79% and kappas were >0.52, indicating good agreement (Table). As expected, lowest agreement was seen for FAST3nJC, since the FM c...

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Fibrofog in Daily Life: An Examination of Ambulatory Subjective and Objective Cognitive Function in Fibromyalgia

Kratz

Whibley

Kim

et al. 2020

Arthritis Care & Research

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Objective. Perceived cognitive dysfunction in fibromyalgia (FM), "fibrofog," is common. Prior laboratory-based studies have limited our understanding of cognitive function in FM in daily life. The objective of this study was to explore levels of subjective and objective cognitive functioning and the association between subjective and objective aspects of cognition in people with and without FM in the lived environment. Methods. Participants (n = 50 adults with FM; n = 50 adults without FM, matched for age, sex, and education) completed baseline measures of subjective and objective cognitive functioning (NIH Toolbox). They also completed ecological momentary assessments of cognitive clarity and speed, and tests of processing speed and working memory, via a smart phone app, 5 times/day for 8 days. Results. On baseline objective measures, the FM group demonstrated poorer cognitive functioning across 3 NIH Toolbox tests. There were no strong correlations between subjective and objective cognitive functioning in both the FM and control groups. In the lived environment, the FM group demonstrated poorer subjective cognition and objective working memory; groups did not differ on processing speed. Momentary ratings of subjective cognitive dysfunction were significantly related to changes in objective processing speed but not working memory, with no group differences. Conclusion. Findings indicate worse laboratory-based and ambulatory subjective and objective cognitive function for those individuals with FM compared to those without FM. Similar associations between measures of subjective and objective cognitive functioning for the groups suggest that individuals with FM are not overstating cognitive difficulties. Future research examining contributors to ambulatory fibrofog is warranted.

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Sleep disturbances in fibromyalgia: A meta-analysis of case-control studies

Cited by 96 publications

References 57 publications

Subjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia

Subjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia

Thu0477 a Fibromyalgia Assessment Screening Tool on a Multidimensional Health Assessment Questionnaire (Mdhaq) Which Does Not Include a Self-Report Painful Joint Count (Painful Jc), Fast3njc, Recognizes Fibromyalgia Similarly to Other Fast3 Indices Which Include a Painful Jc

Fibrofog in Daily Life: An Examination of Ambulatory Subjective and Objective Cognitive Function in Fibromyalgia

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