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

Table 1, highlights that people with FMS most frequently used positive reinterpretation,
acceptance, planning and active coping approaches as coping strategies, rarely relied on
substance use and did not turn to religion to help them to cope. Participants reported
very poor sleep quality with a high median PSQI global score and very low ratings of
enjoyment of sleep and feeling refreshed in the morning. Low levels of health related
quality of life for the sample were revealed by the SF-36 scale scores particularly with
reference to role limitations due to physical problems, pain and fatigue where >85% of
the sample scoring 6 on the PSQI, which is
indicative of clinically significant sleep disturbance requiring intervention. This reveals
that sleep problems are highly prevalent in this sample. The mean PSQI global score for
this sample (as shown in Table 1, p. 62) is comparable to the mean PSQI global score of
13.6 (SD = 3.70) found in patients with other chronic pain conditions (Currie et al,
2000). Participants slept for between 1 and 10 hours each night (mean time asleep 5.95
hours, SD 1.83). This compares to a mean of 6.52 hours in men (+/- 55 minutes) and
7.11 hours (+/- 57 minutes) in women, as revealed in a European general population
study (Jansson & Linton, 2005).
The sleep parameters used to assess clinically significant poor sleep quality (Morin et
al., 1999) suggest that normal sleep onset latency (time taken to fall asleep) should be
30 minutes or less. Sixty one participants (60.40%) in this sample reported taking more
than 30 minutes to fall asleep. It became apparent that participants were experiencing a
high number of awakenings during the night with 73 participants (72.28%) experiencing
more than three awakenings each night. For just under half of the participants (N= 52,
51.49%), these awakenings lasted over 20 minutes. The recommended sleep parameters
also suggest that sleep efficiency should be 80% or over (Jansson & Linton, 2005;
Morin et al., 1999). In this sample only 26/101 (25.74%) met this criteria for sleep
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