Melatonin as a Coadjuvant in the Treatment of Patients with Fibromyalgia.

Fibromyalgia syndrome (FMS) is a chronic widespread pain syndrome that is accompanied by fatigue, sleep disturbances, anxiety, depression, lack of concentration, and neurocognitive impairment. As the currently available drugs are not completely successful against these symptoms and frequently have several side effects, many scientists have taken on the task of looking for nonpharmacological remedies. Many of the FMS-related symptoms have been suggested to be associated with an altered pattern of endogenous melatonin. Melatonin is involved in the regulation of several physiological processes, including circadian rhythms, pain, mood, and oxidative as well as immunomodulatory balance. Preliminary clinical studies have propounded that the administration of different doses of melatonin to patients with FMS can reduce pain levels and ameliorate mood and sleep disturbances. Moreover, the total antioxidant capacity, 6-sulfatoxymelatonin and urinary cortisol levels, and other biological parameters improve after the ingestion of melatonin. Recent investigations have proposed a pathophysiological relationship between mitochondrial dysfunction, oxidative stress, and FMS by looking at certain proteins involved in mitochondrial homeostasis according to the etiopathogenesis of this syndrome. These improvements exert positive effects on the quality of life of FMS patients, suggesting that the use of melatonin as a coadjuvant may be a successful strategy for the management of this syndrome.

Non-supervised breathing exercise regimen in women with fibromyalgia: A quasi-experimental exploratory study.

OBJECTIVES: To know the effectiveness and safety of non-supervised breathing exercise regimen by promoting patients' self-management, and to investigate if non-supervised breathing exercise regimen shows similar benefits to supervised regimen in improving pain and fibromyalgia (FM) impact on daily life. MATERIAL AND METHODS: Fifty-one women with FM were assigned to: supervised breathing exercise regimen group, non-supervised breathing exercise regimen group, and control group. Pain thresholds tolerance on tender points and FM impact on daily life were evaluated. RESULTS: After 12-weeks of breathing exercises statistical differences were not found between supervised and non-supervised regimen. However, supervised regimen showed additional improvements in pain thresholds tolerance and in pain-FIQ subscale. CONCLUSION: Our results suggest that performing a non-supervised breathing exercise program could be as safe and effective as the supervised regimen. However, it was observed that there could be a tendency of supervised exercise regimen to show additional benefits in terms of pain.