Sleep and Sleep Complaints in Juvenile Fibromyalgia Syndrome.

ABSTRACT

OBJECTIVE: To investigate sleep quality in juvenile fibromyalgia syndrome (JFS) and its effect on the global burden of the disease. METHODS: Consecutive patients with JFS who performed full-night polysomnography (PSG) were included in this cross-sectional study. JFS-related symptoms, neuropsychiatric features, and sleep quality were assessed using self-report measures. PSG sleep parameters, including N3 distribution index, were obtained from patients and age-matched healthy controls. RESULTS: We included 25 patients (20 females, median age 15.7 yrs). Nonrestorative sleep was reported by 22 of 25 (88%) patients. Patients with JFS showed significantly longer sleep period time (P = 0.004) and increased wake after sleep onset (P = 0.03) compared to healthy peers. The N3 distribution index was significantly lower in patients than in the control group (P = 0.02). Subjective poor sleep quality was related to Widespread Pain Index (WPI; r s -0.65), Symptom Severity Scale (r s -0.64), depressive symptoms (r s -0.58), fatigue (r s -0.44), and symptom severity upon awakening (r s -0.65). The N3 distribution index was correlated to depressive symptoms (r s 0.41) and irritability (rs 0.40). On multiple regression analysis, WPI was predicted by subjective sleep quality (ß -0.32, P = 0.04), whereas depressive symptoms were predicted by subjective sleep measures (ß -0.32, P = 0.04) and PSG parameters (N3 min ß -0.07, P = 0.03). CONCLUSION: Sleep complaints are a key hallmark of JFS and have significant effect on relevant clinical domains of the disease, such as pain and depression.