Interactions between sleep and pain: the case of fibromyalgia

Whether pain disturbs sleep or vice versa remains a matter of debate. Subjective and objective sleep disturbances are especially prevalent in patients with fibromyalgia. This controversial condition involving chronic, widespread pain is characterized by microstructural patterns of alpha-delta sleep and K-alpha complexes, although their specificity is low. Numerous pathophysiological mechanisms have been proposed, including neuroendocrine dysfunction. Psychological factors are undisputed and may act, according to the biopsychosocial model, through the modulation of pain sensitization. Treatment relies on both pharmacological and non-pharmacological approaches; the goal of relieving pain and improving the quality of sleep are closely related.