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Review Article Open Access
Chronic pain in patients affected by fibromyalgia is nowadays considered as a result of dysregulated mechanisms in the central nervous system. As fibromyalgia patients often report sleep disturbances, some researches have investigated potential central neural dysfunctions which link chronic pain and alterations responsible for sleep disorders. Polysomnography in fibromyalgia patients reveals increased EEG alpha activity during non REM sleep, increased number of arousal and a more frequent occurrence of cyclic alternating pattern. Mechanisms potentially linking chronic widespread pain to sleep alterations and mood disorders have not been proved. The relationship between polysomnographic findings and clinical symptoms in patients with fibromyalgia supports the hypothesis of a conceptual common mechanism called central sensation. The first step in the therapeutic approach is sleep assessment, including sleep history, identification of factors interfering with sleep hygiene and the diagnosis of any underlying disorder that may affect sleep. Food and Drug Administration has approved drugs for fibromyalgia that can improve sleep quality, but not specific for treatment of fibromyalgia associated sleep disorders. Both pharmacological and non pharmacological treatments should be used cautiously in fibromyalgia patients, considering underlying disorders and their potential interactions. However they could be an effective treatment both for fibromyalgia related pain and coexisting sleep alteration.
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Author(s): Maurizio Rizzi, Andrea Cristiano, Francesca Frassanito, Claudio Macaluso, Andrea Airoldi and Piercarlo Sarzi-Puttini
Fibromyalgia, Sleep disorders, Chronic pain, pain management