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

little information was available as to the underlying cause of the condition, let alone
the types of sleep difficulties people perceived they were experiencing. Over the
duration of this thesis, there have been significant advances in our understanding of
the condition, including a movement towards FMS being considered as a neurological,
rather than a rheumatological condition. Consequently, it was important to ensure that
the most current literature was used to inform the interpretation of the findings.
Literature available up until March 2010 has, therefore, been included within this
thesis where most appropriate to make sense of the field and the research. The overall
thesis has been structured into eight chapters following the development of the work
completed:
Chapter One explores the literature on FMS, its impact on both individuals and
society and current treatment approaches.
In Chapter Two, the current knowledge base on sleep and insomnia, and the
factors affecting sleep quality in the general population are discussed.
Chapter Three integrates and extends the information within the first two
chapters by reviewing the literature specifically focusing on sleep in FMS.
In response to the findings of the literature review outlined in the first three
chapters, Chapter Four aims to address some of the gaps identified in the current
literature by exploring the links between sleep quality, coping and other
symptoms of FMS such as pain and fatigue.
Chapter Five extends the findings of the study described in Chapter Four by
examining the psychological factors that may influence sleep quality in FMS, by
comparing people with FMS with healthy controls.
Using a qualitative approach to elaborate on the quantitative findings of the
studies in Chapters Four and Five, Chapter Six examines people‟s experiences
of sleep, the role of sleep on quality of sleep and the meaning of poor sleep
quality for people with FMS. This chapter aims to explore the needs of patients
with FMS, to identify the key areas that would need to be addressed in a
proposed intervention to improve sleep quality.
Chapter Seven pilots an intervention to improve sleep quality for people with
FMS based on the results of the previous studies within this thesis.
The discussion in Chapter Eight combines evidence from the existing literature
with the research conducted within this thesis. Implications of the research
findings for clinical practice and future research are proposed.
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