Sick and Tired: Understanding and Managing Sleep Difficulties in ...
Sick and Tired: Understanding and Managing Sleep Difficulties in ...
Sick and Tired: Understanding and Managing Sleep Difficulties in ...
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Relationships between <strong>Sleep</strong> <strong>and</strong> Pa<strong>in</strong> <strong>in</strong> FMS<br />
Comparable to the f<strong>in</strong>d<strong>in</strong>gs from research <strong>in</strong>to chronic pa<strong>in</strong>, sleep, pa<strong>in</strong> <strong>and</strong> mood have<br />
been found to be significantly correlated <strong>in</strong> FMS. The <strong>in</strong>itial study explor<strong>in</strong>g perceived<br />
sleep quality <strong>in</strong> FMS assessed sleep quality us<strong>in</strong>g the PSQI <strong>and</strong> found that poor sleep<br />
quality, sleep efficiency, <strong>in</strong>creased night-time awaken<strong>in</strong>gs <strong>and</strong> poor overall scores of<br />
sleep quality as assessed by the PSQI global score, were all associated with <strong>in</strong>creased<br />
sensitivity to pa<strong>in</strong>, as assessed by dolorimetry (Agargun et al., 1999). However, this<br />
study did not explore the effect of poor sleep on other symptoms of the condition.<br />
Nicassio et al (2002) asked participants to complete a questionnaire explor<strong>in</strong>g levels of<br />
pa<strong>in</strong>, fatigue, depression <strong>and</strong> sleep quality for the period of one week. Analysis of the<br />
basel<strong>in</strong>e data revealed that as expected, high levels of pa<strong>in</strong> were associated with high<br />
levels of depression <strong>and</strong> fatigue, <strong>and</strong> that there was a negative association with sleep<br />
quality. The data collected over the course of the week was then aggregated to explore<br />
the effect of pa<strong>in</strong> on subsequent sleep quality <strong>and</strong> fatigue. It was revealed that the prior<br />
day‟s pa<strong>in</strong> was associated with poor sleep quality <strong>and</strong> <strong>in</strong>creased fatigue. Interest<strong>in</strong>gly,<br />
sleep quality appeared to mediate the relationship between pa<strong>in</strong> <strong>and</strong> the follow<strong>in</strong>g day‟s<br />
fatigue. This suggests that <strong>in</strong>terventions to improve sleep quality, that have been<br />
effective <strong>in</strong> improv<strong>in</strong>g symptomology <strong>in</strong> other chronic conditions (Lobbezoo, Tanguay,<br />
Thon, & Lavigne, 1996), may improve the experience of FMS symptoms. The measures<br />
used <strong>in</strong> this study however, have limitations. For example, sleep was measured us<strong>in</strong>g<br />
only one item from the sleep subscale of the FIA questionnaire (Mason, Silverman,<br />
Weaver, & Simms, 1992) which focused on feel<strong>in</strong>gs on awaken<strong>in</strong>g from sleep, rather<br />
than ask<strong>in</strong>g directly about perceived sleep quality. It would be expected that feel<strong>in</strong>gs on<br />
awaken<strong>in</strong>g are very likely to be associated with perceived pa<strong>in</strong>, mood <strong>and</strong> fatigue that<br />
day. In addition, complet<strong>in</strong>g the assessments on a daily basis did not enable the above<br />
studies to account for how symptoms may vary over the course of day, therefore the<br />
role of sleep on subsequent symptoms rema<strong>in</strong>s unclear.<br />
In contrast to the research conducted by Nicassio et al (2002), which found that pa<strong>in</strong><br />
impacts on subsequent sleep quality, studies that have been conducted over longer<br />
periods of time have revealed different relationships between pa<strong>in</strong> <strong>and</strong> sleep. In a daily<br />
diary study us<strong>in</strong>g palm top computers to record mood, sleep <strong>and</strong> fatigue over 30<br />
consecutive days by 89 women with FMS, it was revealed that perceived total sleep<br />
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