Sleep and Sleep Complaints in Juvenile Fibromyalgia Syndrome.

Jan 16, 2023

Experts: Clara Malattia,Lorenzo Chiarella,Miriam Sansone,Angela Pistorio,Claudio Lavarello,Manuela Carpaneto,Raffaele Ferri,Angelo Ravelli,Lino Nobili

To investigate sleep quality in juvenile fibromyalgia syndrome (JFS) and its impact on the global burden of the disease.
Consecutive JFS patients who performed full-night polysomnography (PSG) were included in this cross-sectional study. JFS related symptoms, neuropsychiatric features, and sleep quality were assessed using self-report measures. PSG sleep parameters, including N3 distribution index, were obtained from patients and age-matched healthy controls.
We included 25 patients (F 20, median age 15.7 years). Non restorative sleep was reported by 22/25 (88%) patients. JFS patients showed significantly longer Sleep Period Time (P=0.004) and increased wake time after sleep onset (P=0.03) compared to healthy peers. N3 sleep distribution index was significantly lower in patients than in control group (P=0.02). Subjective poor sleep quality was related to Widespread Pain Index (WPI) (r-0.65), symptom severity scale (r-0.64), depressive symptoms (r-0.58), fatigue (r-0.44), and symptoms severity upon awakening (r-0.65). N3 distribution index was correlated to depressive symptoms (r 0.41) and irritability (r 0.40). On multiple regression analysis, WPI was predicted by subjective sleep quality (β= -0.32, P=0.04), whereas depressive symptoms were predicted by subjective sleep measures (β= -0.32, P= 0.04) and PSG parameters (N3 min: β= -0.07, P=0.03).
Sleep complaints are a key hallmark of JFS and has significant impact on relevant clinical domains of the disease, such as pain and depression.

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ABOUT THE EXPERTS

Clara Malattia,Lorenzo Chiarella,Miriam Sansone,Angela Pistorio,Claudio Lavarello,Manuela Carpaneto,Raffaele Ferri,Angelo Ravelli,Lino Nobili

Clara Malattia

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Lorenzo Chiarella

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Miriam Sansone

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Angela Pistorio

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Claudio Lavarello

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Manuela Carpaneto

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Raffaele Ferri

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Angelo Ravelli

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.

Lino Nobili

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Genoa, Italy. Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy. SS Antonio e Biagio e Cesare Arrigo Hospital, Child Neuropsychiatry Unit, Alessandria, Italy Sleep Research Centre, Oasi Institute Research – IRCCS, Troina, Italy. Funding: This study was supported by the Italian Ministry of Health, 5×1000 project 2017 “SOLAR: Sleep disorders in children: an innovative clinical research perspective”. Address correspondence to Dr.Clara Malattia, Clinica Pediatrica Reumatologia, IRCCS Istituto G. Gaslini, Via G. Gaslini 5, 16147 Genova Italy. E-mail: claramalattia@gaslini.org.