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Fibromyalgia, sleep disturbance and menopause: Is there a relationship? A literature review

International Journal of Rheumatic Diseases Oct 24, 2019

Dias RCA, et al. - Through this review, experts assessed publications that noted the impacts of menopause and sleep disturbance in building or exacerbating fibromyalgia (FM, characterized by the presence of persistent and widespread pain related to multiple clinical symptoms like sleep disturbance, fatigue, cognitive dysfunction, and depression, which is one of the prevalent diagnoses in rheumatologic outpatient clinics), as well as the role of hormone therapy (HT) for these patients and compared the methodologies of these studies, investigated the diagnostic criteria used, assessed quality of sleep (subjective or objective) pain intensity, and quality of life, and ascertained the role of the aforementioned menopause symptoms. The objective sleep patterns of FM cases involved high sleep latency, recurrent arousals, and intrusion of alpha wave sleep and NREM (non-rapid eye movement) sleep in delta sleep. In the late perimenopause and surgical menopause, poor sleep during menopause is more prevalent and may be associated with vasomotor symptoms or not. On the subjective sleep quality of symptomatic menopausal women, HT had a positive impact. Studies revealed a high relationship between FM and early and surgical menopause. In FM individuals, raloxifene had a positive impact on pain and sleep; though, one study that investigated the impacts of transdermal estrogen therapy saw no betterment in subjective and objective parameters of pain. Nonetheless, in order to illustrate the nature of the correlation between menopause, sleep, and persistent pain syndromes, like FM, revealing the role of hormone therapy in prospective placebo-controlled trials, additional studies are required.
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