Sleep and Sleep Complaints in Juvenile Fibromyalgia Syndrome

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 (r_s 0.40). On multiple regression analysis, WPI was predicted by subjective sleep quality (β −0.32, P = 0.04), whereas depressive symptoms were predicted by subjective sleep measures (β −0.32, P = 0.04) and PSG parameters (N3 min: β −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.