Posted by Phillipa on November 16, 2011, at 18:18:24
Looks like insomnia and sleep deprevation can lead to fibromyalgia in middle aged women. Of course as usual females. Phillipa
From Medscape Medical News
Sleep Disorder Linked to Fibromyalgia Risk
Janis C. KellyAuthors and Disclosures
November 16, 2011 Women with no history of fibromyalgia (FM) are more likely to develop the chronic musculoskeletal pain disorder if they have sleep problems, according to a groundbreaking new study.
Paul J. Mork, DPhil, and Tom I.L. Nilsen, DPhil, from Norwegian University of Science and Technology in Trondheim, Norway, report online November 14 in Arthritis & Rheumatism that fibromyalgia risk was 5-fold higher in women older than age 45 years who reported "often" or "always" having sleep problems than in women with normal sleep.
Dr. Mork told Medscape Medical News, "This was a prospective study investigating whether sleep problems increase the risk of FM in women that were pain-free at baseline. Thus, the implications of the study are more related to how to prevent FM than to the management/treatment of FM or sleep disorders. It is well known that sleep problems are related to increased risk of other chronic diseases (eg, cardiovascular disease), but this study is the first to show the relation to chronic widespread pain. Sleep problems should be taken seriously, and early detection and proper treatment may decrease risk of FM as well as other chronic diseases."
The risk for fibromyalgia increased with severity of sleep problems, and the association was stronger among middle-aged and older women than among younger women.
The prospective study, known as the HUNT study, included 10 years of longitudinal data for 12,350 women who were free of fibromyalgia, musculoskeletal pain, and physical impairments at baseline in 1984 to 1986. The researchers used a generalized linear model to calculate adjusted relative risks (RRs) of FM at follow-up in 1995 to 1997, at which time 327 women had developed FM (incidence, 2.6%).
The adjusted relative risk among women who reported having sleep problems "often" or "always" was 5.41 among women older than age 45 years and 2.98 among those aged 20 to 44 years. The authors suggest that further studies are needed to investigate whether early detection and treatment of sleep disturbance reduce the risk for fibromyalgia in women.
Dr. Mork said, "We were somewhat surprised that the association was that strong, ie, more than 5-fold increase in risk among middle-aged and older women who reported to have sleep problems often/always, even after adjusting our risk estimates for several potential confounding factors that may interfere with sleep (including age, exercise, body mass index, psychological well-being, smoking, and education)."
Silvia M. Bigatti, PhD, from the Department of Public Health at Indiana University School of Medicine in Indianapolis, reviewed the study for Medscape Medical News. Dr. Bigatti said, "I think [the study] is excellent. We should not overinterpret the findings, though. All the findings suggest is that women with sleep problems are more likely to develop FM in the future than women without sleep problems."
She continued, "The findings support earlier research that found sleep related to FM, and sleep as a predictor of FM, when examined over time...Mork et al confirmed this over a longer period of time than anyone had done before, and with a larger group than anyone had examined before. [They] also controlled for potential important variables such as depression.
"However, we don't know that sleep problems cause FM," Dr. Bigatti pointed out. "It could be that whatever was causing the sleep problems in the women also caused FM, or that whatever the sleep problems caused could have then caused FMS. [This study] is not definitive, but it is one more piece in the puzzle that shows that sleep problems and FM are connected, and that sleep problems precede FM and symptoms."
Dr. Mork added, "The exact mechanism(s) by which poor sleep can cause chronic widespread pain is uncertain. Previous experimental studies have shown that sleep deprivation is associated with development of mechanical hyperalgesia (ie, lowered pain pressure threshold) at multiple body sites. Moreover, sleep deprivation has also been associated with elevated plasma levels of inflammatory markers and reduced endogenous pain-inhibitory capacity. Whether these mechanisms contribute to the development of FM should be investigated in future studies."
Carol Landis, DNSc, professor of nursing at the University of Washington, Seattle, also reviewed the study for Medscape Medical News. Ms. Landis said, "The results of this study are important because it is the first prospective study to show self-report of poor sleep increases the relative risk for the development of fibromyalgia in otherwise healthy women. The investigators acknowledge several important limitations in the study and were able to control for some important confounding variables.
"However, they did not control for menopausal status in the cohort of middle-aged women," she said. "They also did not control for stressful life events such as physical illness or trauma. Such events are associated with insomnia and reported by as many as 50% of subjects with FM in some studies. Thus, the claim that sleep problems cause FM in two-thirds of women with FM may not hold up in future prospective studies of this nature."
The study authors have disclosed no relevant financial relationships. Dr. Bigatti and Ms. Landis have disclosed no relevant financial relationships.
Arthritis Rheum. Published online November 14, 2011
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