Fibromyalgia: The Role of Sleep in Affect and in Negative Event Reactivity and Recovery

Department of Psychology, University of Kansas, USA.
Health Psychology (Impact Factor: 3.59). 07/2008; 27(4):490-7. DOI: 10.1037/0278-6133.27.4.490
Source: PubMed


Fibromyalgia (FM) syndrome is a chronic pain condition characterized by diffuse muscle pain, increased negative mood, and sleep disturbance. Until recently, sleep disturbance in persons with FM has been modeled as the result of the disease process or its associated pain. The current study examined sleep disturbance (i.e., sleep duration and sleep quality) as a predictor of daily affect, stress reactivity, and stress recovery.
A hybrid of daily diary and ecological momentary assessment methodology was used to evaluate the psychosocial functioning of 89 women with FM. Participants recorded numeric ratings of pain, fatigue, and positive and negative affect 3 times throughout the day for 30 consecutive days. At the end of each day, participants completed daily diary records of positive and negative life events. In addition, participants reported on their sleep duration and sleep quality each morning.
After accounting for the effects of positive events, negative events, and pain on daily affect scores, it was found that sleep duration and quality were prospectively related to affect and fatigue. Furthermore, the effects of inadequate sleep on negative affect were cumulative. In addition, an inadequate amount of sleep prevented affective recovery from days with a high number of negative events.
These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning.

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Available from: Jonathan L Templin, Oct 07, 2015
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    • "In the current study, we reexamined the pre-and postintervention diary data to evaluate the effects of the CBT-P, M, and E conditions on day-to-day pain and stress reactivity via the 30 daily diary reports obtained at pre-and postintervention. We use the term " reactivity " to refer to daily within-person changes in cognitions , fatigue and morning disability, and affect associated with daily changes in pain and stress (Hamilton et al., 2008; Suls & Martin, 2005). Improvement in reactivity would be manifested by weakened relations between daily changes in pain or stress and daily cognitions, symptoms, and affect from pre-to posttreatment. "
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    ABSTRACT: Objective: This study compared the impact of cognitive-behavioral therapy for pain (CBT-P), mindful awareness and acceptance treatment (M), and arthritis education (E) on day-to-day pain- and stress-related changes in cognitions, symptoms, and affect among adults with rheumatoid arthritis (RA). Method: One hundred forty-three RA patients were randomized to 1 of the 3 treatment conditions. CBT-P targeted pain-coping skills; M targeted awareness and acceptance of current experience to enhance coping with a range of aversive experiences; E provided information regarding RA pain and its management. At pre- and posttreatment, participants completed 30 consecutive evening diaries assessing that day's pain, fatigue, pain-related catastrophizing and perceived control, morning disability, and serene and anxious affects. Results: Multilevel models compared groups in the magnitude of within-person change in daily pain and stress reactivity from pre- to posttreatment. M yielded greater reductions than did CBT-P and E in daily pain-related catastrophizing, morning disability, and fatigue and greater reductions in daily stress-related anxious affect. CBT-P yielded less pronounced declines in daily pain-related perceived control than did M and E. Conclusions: For individuals with RA, M produces the broadest improvements in daily pain and stress reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life.
    Journal of Consulting and Clinical Psychology 11/2014; 83(1). DOI:10.1037/a0038200 · 4.85 Impact Factor
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    • "There is less consistent evidence of the associations between NA and PA and subjective and objective measures of sleep in naturalistic environments. Although two early studies of healthy adolescents found small (Price, Coates, Thoresen, & Grinstead, 1978) or no associations (Clark & Watson, 1988) between subjective sleep and negative emotional states, most studies have been conducted in adult or clinical populations (Bower, Bylsma, Morris, & Rottenberg, 2010; Cousins et al., 2011; Hamilton et al., 2008). For example, in a diary study of older adults, subjective, but not objective, assessments of sleep were significantly correlated with less PA and greater NA the next day (McCrae et al., 2008). "
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    ABSTRACT: The present study examined the dynamic associations among daily stress levels, affect, and objective sleep quality in adolescence. We also explored loneliness as a potential moderator of these associations. Seventy-eight adolescents participated over three days. They completed diary reports of stressful experiences and affect five times a day while wearing an actigraph to obtain objective measurement of sleep. They also provided self-reports of loneliness. High daily stress was associated with shorter sleep duration. Models testing bidirectional associations indicated that prior day stress was associated with shorter sleep duration, but poor sleep duration and sleep efficiency were also associated with greater stress the next day. Loneliness was a significant moderator of the associations between daily stress and sleep duration and latency such that lonely individuals had shorter sleep durations and sleep latencies after particularly stressful days. Results suggest daily dynamic associations among loneliness, daily stress, and objective measures of adolescent sleep.
    Journal of Adolescence 02/2014; 37(2):145–154. DOI:10.1016/j.adolescence.2013.11.009 · 2.05 Impact Factor
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    • "Along these lines, a recent prospective study has identified a strong association between sleep problems and risk of FM among adult women (Mork & Nilsen, 2012). Moreover, several clinical studies have evidenced the complex relationship between sleep disturbances and other clinical manifestations of FM, showing that sleep quality may influence pain, fatigue, mood state, cognitive performance and daily functioning (Bigatti et al., 2008; Hamilton et al., 2008, 2012; Nicassio et al., 2002; Miró et al., 2011a, c; Theadom et al., 2007; for a review, see Prados & Miró, 2012). For example, Nicassio et al. (2002) examined the relationship between pain, sleep, fatigue and depression in FM patients, noting that in the cross-sectional assessment greater depression and lower sleep quality were associated with higher fatigue, and in the prospective daily assessment the previous day's pain and sleep quality predicted the next day's fatigue. "
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    ABSTRACT: Sleep disturbances play an important role in the exacerbation of pain and other troubling symptoms reported by patients with fibromyalgia (FM). The objective of this trial was to analyze the efficacy of a cognitive-behavioral therapy for insomnia (CBT-I) versus a sleep hygiene (SH) education program at improving sleep and other clinical manifestations in FM. Sixty-four FM women with insomnia were randomly assigned to the CBT-I or the SH groups, and 59 completed the treatments (30 in the CBT-I group and 29 in the SH group). Participants completed several self-report questionnaires at pre-, post-treatment and follow-ups. The CBT-I group reported significant improvements at post-treatment in several sleep variables, fatigue, daily functioning, pain catastrophizing, anxiety and depression. The SH group only improved significantly in subjective sleep quality. Patients in the CBT-I group showed significantly greater changes than those in the SH group in most outcome measures. The findings underscore the usefulness of CBT-I in the multidisciplinary management of FM.
    Journal of Behavioral Medicine 06/2013; 37(4). DOI:10.1007/s10865-013-9520-y · 3.10 Impact Factor
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