Abstract
Understanding individual differences in the variability of fibromyalgia pain can help
elucidate etiological mechanisms and treatment targets. Past research has shown that
spatial extent of pain, negative mood, and aftersensation (pain ratings taken after
experimental induction of pain) accounts for 40 to 50% of the variance in clinical
pain. Poor sleep is hypothesized to have a reciprocal relationship with pain, and
over 75% of individuals with fibromyalgia report disturbed sleep. We hypothesized
that measures of sleep would increase the predictive ability of the clinical pain
model. Measures of usual pain, spatial extent of pain, negative mood, and pain aftersensation
were taken from 74 adults with fibromyalgia. Objective (actigraph) and subjective
(diary) measures of sleep duration and nightly wake time were also obtained from the
participants over 14 days. Hierarchical regression indicated that greater spatial
extent (R2 = .26), higher aftersensation ratings (R2 = .06), and higher negative mood (R2 = .04) accounted for 36% of the variance in clinical pain (average of 14 daily pain
ratings). None of the sleep variables were significant predictors of clinical pain.
Results replicate previous research and suggest that spatial extent of pain, pain
aftersensation, and negative mood play important roles in clinical pain, but sleep
disturbance did not aid in its prediction.
Perspective
This study suggests that measures of sleep duration and nightly wake time do not predict
fibromyalgia pain at the group level. Fibromyalgia patients may benefit from a 3-pronged
approach to pain management: reducing pain’s spatial extent, normalization of central
nervous system hypersensitivity, and psychobehavioral therapies for negative mood.
Key words
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Article info
Publication history
Published online: March 02, 2012
Accepted:
December 22,
2011
Received in revised form:
December 8,
2011
Received:
September 22,
2011
Footnotes
Support provided by a grant from the National Institutes of Health (R01 AR055160) to Dr. McCrae and Dr. Robinson.
Identification
Copyright
© 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
