Choy Ernest H
Section of Rheumatology, Institute of Infection & Immunity, Cardiff University School of Medicine, Cardiff University, Cardiff, UK.
Pain Manag. 2016 May;6(4):339-46. doi: 10.2217/pmt-2016-0009. Epub 2016 Jun 17.
Fibromyalgia is characterized by chronic widespread pain, fatigue and nonrestorative sleep. Polysomnography showed reduced short-wave sleep and abnormal alpha rhythms during nonrapid eye movement sleep in patients with fibromyalgia. However, sleep dysfunction might be pathogenic in fibromyalgia since myalgia and fatigue could be induced in healthy individuals by disrupting sleep. Poor sleep quality was a major risk factor for the subsequent development of chronic widespread pain in healthy pain-free individuals. Sleep disruption leads to impairment of the descending pain inhibition pathways. Aside from good sleep, hygiene, exercise can promote sleep. Among currently available pharmacological treatments, evidence suggests amitriptyline and pregabalin can improve sleep in fibromyalgia.
纤维肌痛的特征是慢性广泛性疼痛、疲劳和睡眠无法恢复精力。多导睡眠图显示，纤维肌痛患者在非快速眼动睡眠期间短波睡眠减少且出现异常α节律。然而，睡眠功能障碍在纤维肌痛中可能具有致病性，因为干扰睡眠可在健康个体中诱发肌痛和疲劳。睡眠质量差是健康无疼痛个体随后发生慢性广泛性疼痛的主要危险因素。睡眠中断会导致下行性疼痛抑制通路受损。除了良好的睡眠卫生习惯外，运动也可以促进睡眠。在目前可用的药物治疗中，有证据表明阿米替林和普瑞巴林可以改善纤维肌痛患者的睡眠。
