Prados G, Miro E
Servicio de Medicina Interna, Hospital Universitario Virgende las Nieves, Universidad de Granada, Granada, España.
Rev Neurol. 2012 Feb 16;54(4):227-40.
Although medical literature has devoted little attention to sleep compared to other symptoms of fibro-myalgia, the American College of Rheumatology has recently proposed that sleep should be a central aspect of the clinical assessment of fibromyalgia. Despite this, no comprehensive reviews have encompassed the physiopathological, psycho-social and therapeutic aspects of the relationship between sleep and fibromyalgia.
A bibliographic search of the terms 'fibromyalgia' and 'sleep' was made in the platforms Scopus and OVID (Medline, PsychINFO and Ovid Nursing Database) from 1 January 1990 to 31 August 2011. After applying certain inclusion criteria, 112 records were selected.
The importance of sleep in this syndrome is increasingly being understood thanks to the progress made in research on fibromyalgia and the use of biopsychosocial explanatory models. Many studies have shown complex inter-actions between sleep disturbances, neuroendocrine and immune abnormalities and the clinical symptoms present in fibromyalgia. Such interactions suggest that sleep disturbances may be both a cause and a consequence of fibromyalgia. Although sleep improvement contributes to alleviating various symptoms of fibromyalgia, there are few effective drugs available and their use has some disadvantages. Regarding other non-drug therapies, it is important to highlight the promising findings of cognitive-behavioral therapy and aerobic exercise. Future research should determine the advantages of each of these treatments and assess their cost-effectiveness.
与纤维肌痛的其他症状相比,医学文献对睡眠的关注较少,不过美国风湿病学会最近提出,睡眠应成为纤维肌痛临床评估的核心内容。尽管如此,尚无全面综述涵盖睡眠与纤维肌痛之间关系的生理病理、心理社会及治疗方面。
于2011年8月31日至1990年1月1日期间,在Scopus和OVID平台(医学期刊数据库、心理学文摘数据库及Ovid护理学数据库)中,以“纤维肌痛”和“睡眠”为关键词进行文献检索。在应用了某些纳入标准后,共筛选出112条记录。
得益于纤维肌痛研究的进展以及生物心理社会解释模型的应用,睡眠在该综合征中的重要性正日益得到理解。许多研究表明,睡眠障碍、神经内分泌及免疫异常与纤维肌痛的临床症状之间存在复杂的相互作用。这种相互作用表明,睡眠障碍可能既是纤维肌痛的一个病因,也是其一个后果。尽管改善睡眠有助于缓解纤维肌痛的各种症状,但有效的药物很少,且使用这些药物存在一些弊端。关于其他非药物疗法,认知行为疗法和有氧运动的前景值得关注。未来的研究应确定这些治疗方法各自的优势,并评估其成本效益。