• Sleep · Apr 2013

    Relationship between sleep and pain in adolescents with juvenile primary fibromyalgia syndrome.

    • Margaret N Olsen, David D Sherry, Kathleen Boyne, Rebecca McCue, Paul R Gallagher, and Lee J Brooks.
    • Division of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
    • Sleep. 2013 Apr 1;36(4):509-16.

    Study ObjectivesTo investigate sleep quality in adolescents with juvenile primary fibromyalgia syndrome (JPFS) and determine whether sleep abnormalities, including alpha-delta sleep (ADS), correlate with pain intensity. We hypothesized that successful treatment for pain with exercise therapy would reduce ADS and improve sleep quality.DesignSingle-center preintervention and postintervention (mean = 5.7 ± 1.0 weeks; range = 4.0-7.3 weeks) observational study.PatientsTen female adolescents (mean age = 16.2 ± 0.65 SD yr) who met criteria for JPFS and completed treatment.InterventionsMultidisciplinary pain treatment, including intensive exercise therapy.Measurements And ResultsPain and disability were measured by a pain visual analog scale (VAS) and the functional disability inventory. Subjective sleep measures included a sleep VAS, an energy VAS, and the School Sleep Habits Survey. Objective sleep measures included actigraphy, polysomnography (PSG), and the Multiple Sleep Latency Test. Baseline PSG was compared with that of healthy age- and sex-matched control patients. At baseline, patients had poorer sleep efficiency, more arousals/awakenings, and more ADS (70.3% of total slow wave sleep [SWS] versus 21.9% SWS, P = 0.002) than controls. ADS was unrelated to pain, disability, or subjective sleep difficulty. After treatment, pain decreased (P = 0.000) and subjective sleep quality improved (P = 0.008). Objective sleep quality, including the amount of ADS, did not change.ConclusionsAlthough perceived sleep quality improved in adolescents with JPFS after treatment, objective measures did not. Our findings do not suggest exercise therapy for pain improves sleep by reducing ADS, nor do they support causal relationships between ADS and chronic pain or subjective sleep quality.

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