Roizenblatt S, Tufik S, Goldenberg J, Pinto L R, Hilario M O, Feldman D
Department of Rheumatology, Universidade Federal de Sao Paulo, Brazil.
J Rheumatol. 1997 Mar;24(3):579-85.
To identify the child-mother diagnostic correlation in fibromyalgia (FM), to study sleep disturbance in juvenile FM, and to compare clinical aspects and sleep disorders between these groups.
We studied 34 children with confirmed FM aged 11 +/- 1 years, 10 children with diffuse pain, and 17 age and sex matched asymptomatic controls. The respective 61 mothers were included: 34 asymptomatic and 27 with FM. All participants were subjected to clinical evaluation, a sleep questionnaire, and nocturnal polysomnography, preceded by a night of adaptation. Sleep scoring was done visually and a computerized analysis was performed for alpha, theta, and delta waves in slow wave sleep (SWS).
A significant predominance of mothers with FM was observed in the group of children with FM (71%) compared to children with diffuse pain (30%) and asymptomatic children (0%). According to the sleep questionnaire, the complaints of superficial sleep and nonrestorative sleep were more prominent in mothers with FM than in children with FM, whereas motor agitation during sleep was more frequent in the children with FM. Polysomnographic anomalies were also more prominent in mothers with FM than in children with FM in terms of decrease in sleep efficiency, increase of number of arousals during sleep, and alpha intrusion in SWS. Both FM groups presented an increased alpha + theta time/delta time index during SWS compared to respective controls, and mothers with FM also showed an increase in alpha time/delta time index during SWS, compared to asymptomatic mothers. A correlation was found between alpha + theta time/delta time index during SWS and intensity of clinical manifestations of pain and sleep anomalies in children and their mothers.
Significant concordance was observed regarding FM diagnosis in children and their mothers. Sleep complaints and polysomnography findings were less prominent in affected children compared to mothers with FM. In addition, we observed a significant correlation between polysomnographic indexes, sleep anomalies, and pain manifestations in children and their mothers.
确定纤维肌痛（FM）患儿与母亲的诊断相关性，研究青少年FM的睡眠障碍，并比较这些组之间的临床特征和睡眠障碍。
我们研究了34名确诊为FM的11±1岁儿童、10名有弥漫性疼痛的儿童以及17名年龄和性别匹配的无症状对照者。纳入了各自的61名母亲：34名无症状，27名患有FM。所有参与者均接受临床评估、睡眠问卷和夜间多导睡眠图检查，检查前先进行一晚的适应性观察。睡眠评分采用视觉评分法，并对慢波睡眠（SWS）中的α波、θ波和δ波进行计算机化分析。
与有弥漫性疼痛的儿童（30%）和无症状儿童（0%）相比，FM患儿组中患有FM的母亲占比显著更高（71%）。根据睡眠问卷，FM母亲的浅睡眠和无恢复性睡眠主诉比FM患儿更突出，而FM患儿睡眠中的运动躁动更频繁。在睡眠效率降低、睡眠中觉醒次数增加以及SWS中α波侵入方面，FM母亲的多导睡眠图异常也比FM患儿更突出。与各自的对照组相比，两个FM组在SWS期间的α + θ时间/δ时间指数均升高，与无症状母亲相比，FM母亲在SWS期间的α时间/δ时间指数也升高。发现SWS期间的α + θ时间/δ时间指数与儿童及其母亲的疼痛临床表现强度和睡眠异常之间存在相关性。
在儿童及其母亲的FM诊断方面观察到显著的一致性。与FM母亲相比，受影响儿童的睡眠主诉和多导睡眠图结果不那么突出。此外，我们观察到儿童及其母亲的多导睡眠图指数、睡眠异常和疼痛表现之间存在显著相关性。
