Sick and Tired: Understanding and Managing Sleep Difficulties in ...

Conclusion
Poor sleep quality can affect all aspects of a person‟s daily functioning, and for people
with FMS the effects are even more profound. The key contributions to knowledge
reflected in this thesis are that sleep disturbance was more highly prevalent in FMS than
previously described, and that poor sleep was linked to the exacerbation of symptoms of
pain, fatigue and reduced social functioning. In particular, frequent night-time
awakenings, while feeling mentally alert at night, was found to be the most common
difficulty, with people experiencing sleep in blocks of two to three hours throughout the
night. This contrasts to people with other chronic pain conditions, who have been found
to experience greater difficulties with initial sleep onset and reduced total sleep time.
Undiagnosed sleep disorders may also be particularly problematic for people with FMS
and routine screening should be recommended. This thesis also highlighted that
psychological factors such as high negative affect, stress and dysfunctional beliefs about
sleep were found to be associated with greater sleep disturbance.
While there are important advances still to be made (such as exploring if daytime
napping is a beneficial management strategy for this population), the findings from this
thesis have important implications for treatment. Interventions that identify sleep
difficulties and manage the psychological aspects, in addition to the environmental and
physiological aspects of sleep disturbance, should form an integral part of treatment to
improve quality of life for people with FMS. Findings indicate that a brief mindfulness
body scan intervention may provide one component of an intervention to address the
psychological aspects of sleep disturbance. While some continue to trivialise sleep
problems and the consequences of disturbed sleep, the studies incorporated within this
thesis have identified the importance of sleep disturbance on health, and has contributed
to potential ways forward in managing poor sleep for people with FMS.
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