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Fibromyalgia (FM)--a syndrome associated with decreased nocturnal melatonin secretion

  [ 58 votes ]   [ Discuss This Article ]
By Wikner J, Hirsch U, Wetterberg L, Rojdmark S • • August 25, 1998

OBJECTIVE: Most patients with fibromyalgic syndrome (FMS)
complain of sleep disturbances, fatigue, and pain. These
symptoms might be a consequence of changed melatonin (MT)
secretion, since MT is known to have sleep promoting
properties. Moreover, serum concentrations of two MT
precursors (tryptophan and serotonin)--affecting both sleep
and pain perception--appear to be low in patients with FMS.
Therefore, the objective of this investigation was to study
whether serum MT (s-MT) level is also low in these patients.

DESIGN: Eight patients with FMS and 8 healthy sex-, BMI-, and
age-matched controls were included in the study. s-MT
concentrations were determined every second hour between 1800
and 0800 h. Urine was collected between 2200 and 0700 h for
determination of urinary MT excretion. To evaluate total MT
secretion between 1800 and 0800 h and MT secretion during the
hours of darkness (between 23 and 07 h) individual MT areas
under the curve (AUC) were calculated and expressed as group

RESULTS: The FMS patients had a 31% lower MT secretion
than healthy subjects during the hours of darkness (MT AUC
2300-0700 h (mean +/- SEM): 1.70 +/- 0.17 vs 2.48 +/- 0.38
nmol/l; P < 0.05). Also the s-MT peak value was significantly
lower in the patient group: 0.28 +/- 0.03 vs 0.44 +/- 0.06
nmol/l; P < 0.05).

CONCLUSION: Patients with fibromyalgic
syndrome have a lower melatonin secretion during the hours of
darkness than healthy subjects. This may contribute to
impaired sleep at night, fatigue during the day, and changed
pain perception.

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