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.