B. Pathogenesis 1. Stage 4 sleep anomaly. This is similar to normal healthy sleep with stage 4 deprivation, ie, noise. Abnormal neurohormonal homeostasis. Muscle microtrauma, inactivity, deconditioning.
Patients frequently exhibit depressive symptoms, poor pain coping mechanisms.
C. Spectrum of FMS and related disorders. Several disorders with similar etiopathogenesis and overlapping clinical manifestations. Stage 4 sleep anomaly unifying underlying pathogenic mechanism. Often associated with musculoskeletal pare and fatigue. Tension headaches, TMJ syndrome, noncardiac chest pain.