Wu Yu-Lin, Chang Ling-Yin, Lee Hsin-Chien, Fang Su-Chen, Tsai Pei-Shan
School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Division of Child Health Research, Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.
J Psychosom Res. 2017 May;96:89-97. doi: 10.1016/j.jpsychores.2017.03.011. Epub 2017 Mar 23.
Sleep disturbances are common in fibromyalgia, but the features of sleep disturbances are not well understood. We performed a systematic review and meta-analysis of case-control studies to compare the sleep outcomes of individuals with fibromyalgia and healthy controls.
We systematically searched eight databases (PubMed, Ovid MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Airiti Library and Wanfang Data) for articles published before April 2016.
Twenty-five case-controlled studies and a total of 2086 participants were included in the meta-analysis. Sleep was assessed using polysomnography and the Pittsburgh Sleep Quality Index. When sleep was assessed using polysomnography (19 studies), significant differences were observed in wake time after sleep onset (g=0.81, 95% confidence interval [CI] 0.21-1.41), total sleep time (g=-0.78, 95% CI=-1.34 to -0.15), sleep efficiency (g=-0.78, 95% CI=-1.23 to -0.32), percentage of stage 1 sleep (g=0.55, 95% CI=0.15-0.95), and percentage of slow-wave sleep (g=-0.66, 95% CI=-1.21 to -0.12) between participants with fibromyalgia and healthy controls. When sleep was assessed using the Pittsburgh Sleep Quality Index (7 studies), significant differences were observed in global scores (g=2.19, 95% CI 1.58-2.79), sleep onset latency (g=1.75, 95% CI 0.80-2.70), and sleep efficiency (g=-1.08, 95% CI -1.65 to -0.51) between participants with fibromyalgia and healthy controls.
Individuals with fibromyalgia experience lower sleep quality and sleep efficiency; longer wake time after sleep onset, short sleep duration, and light sleep when objectively assessed and more difficulty in initiating sleep when subjectively assessed. Sleep difficulties in fibromyalgia appear to be more when reported subjectively than when assessed objectively.
This study received no funding from any source. All authors declare that they have no conflict of interest. This article does not contain any studies with human participants performed by any of the authors.
睡眠障碍在纤维肌痛中很常见，但睡眠障碍的特征尚未得到充分了解。我们对病例对照研究进行了系统评价和荟萃分析，以比较纤维肌痛患者和健康对照者的睡眠结果。
我们系统检索了8个数据库（PubMed、Ovid MEDLINE、Embase、CINAHL、PsycINFO、Web of Science、华艺数位图书馆和万方数据），查找2016年4月之前发表的文章。
荟萃分析纳入了25项病例对照研究，共2086名参与者。使用多导睡眠图和匹兹堡睡眠质量指数评估睡眠。当使用多导睡眠图评估睡眠时（19项研究），纤维肌痛患者和健康对照者在睡眠开始后的清醒时间（g=0.81，95%置信区间[CI]0.21-1.41）、总睡眠时间（g=-0.78，95%CI=-1.34至-0.15）、睡眠效率（g=-0.78，95%CI=-1.23至-0.32）、1期睡眠百分比（g=0.55，95%CI=0.15-0.95）和慢波睡眠百分比（g=-0.66，95%CI=-1.21至-0.12）方面存在显著差异。当使用匹兹堡睡眠质量指数评估睡眠时（7项研究），纤维肌痛患者和健康对照者在总体评分（g=2.19，95%CI 1.58-2.79）、入睡潜伏期（g=1.75，95%CI 0.80-2.70）和睡眠效率（g=-1.08，95%CI -1.65至-0.51）方面存在显著差异。
纤维肌痛患者的睡眠质量和睡眠效率较低；客观评估时，睡眠开始后的清醒时间更长、睡眠时间短且睡眠浅，主观评估时入睡更困难。纤维肌痛患者的睡眠困难主观报告似乎比客观评估时更多。
本研究未获得任何来源的资金。所有作者声明他们没有利益冲突。本文不包含任何作者进行的涉及人类参与者的研究。
