While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .
Effects of Sodium Oxybate on Sleep Physiology and Sleep/Wake-related Symptoms in Patients with Fibromyalgia Syndrome: A Double-blind, Randomized, Placebo-controlled Study
Objective . To determine the effects of sodium oxybate ( SXB ) on sleep physiology and sleep/wake-related symptoms in patients with fibromyalgia syndrome ( FM ) . Methods . Of 304 patients with FM ( American College of Rheumatology tender point criteria ) in the screened study population , 209 underwent polysomnography , 195 were r and omized , and 151 completed this 8-week , double-blind , placebo-controlled study of SXB 4.5 g and 6 g/night . We evaluated changes in objective sleep measures and subjective symptoms , including daytime sleepiness [ Epworth Sleepiness Scale ( ESS ) ] , fatigue visual analog scale ( FVAS ) , sleep [ Jenkins Scale for Sleep ( JSS ) ] , and daytime functioning [ Functional Outcome of Sleep Question naire ( FOSQ ) , SF-36 Vitality domain , and Fibromyalgia Impact Question naire ( FIQ ) general and morning tiredness ] . Results . Pretreatment screening revealed an elevated incidence of maximum alpha EEG-intrusion > 24 min/hour of sleep ( 66 % ) , periodic limb movements of sleep ( 20.1 % ≥ 5/hour ) , and moderate to severe obstructive sleep apnea disorder ( 15.3 % apnea-hypopnea index ≥ 15/hour ) . Compared with placebo , both doses of SXB achieved statistically significant improvements in ESS , morning FVAS , JSS , FOSQ , SF-36 Vitality , and FIQ general and morning tiredness ; both doses also demonstrated decreased rapid eye movement ( REM ) sleep ( all p ≤ 0.040 ) . SXB 6 g/night improved afternoon , evening and overall FVAS , reduced wakefulness after sleep onset , and increased Stage 2 , slow-wave , and total non-REM sleep ( all p ≤ 0.032 ) versus placebo . Moderate correlations ( ≥ 0.40 ) were noted between changes in subjective sleep and pain measures . Adverse events occurring significantly more frequently with SXB than placebo were nausea , pain in extremity , nervous system disorders , dizziness , restlessness , and renal/urinary disorders ( including urinary incontinence ) . Conclusion . This large cohort of patients with FM demonstrated that SXB treatment improved EEG sleep physiology and sleep-related FM symptoms
While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .