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Sleep electroencephalography & the clinical response to amitriptyline in patients with fibromyalgia (FM)

  [ 26 votes ]   [ Discuss This Article ]
www.ProHealth.com • September 10, 1995


OBJECTIVE. To determine the prevalence and clinical correlations of
an anomaly consisting of electroencephalographic (EEG) waves
within the alpha frequency band during non-rapid eye movement
(NREM) sleep in patients with fibromyalgia, and to evaluate
the alpha NREM sleep anomaly as a predictor of response to
amitriptyline.

METHODS. Twenty-two patients with fibromyalgia
were studied in a 2-month, double-blind, crossover trial of
amitriptyline (25 mg/day) versus placebo. Nocturnal EEGs were
conducted on 2 consecutive nights at baseline and at the end
of each 2-month treatment period.

RESULTS. Six patients (27%)
had a clinical response to amitriptyline, while none responded
to placebo (P = 0.02). Treatment with amitriptyline or placebo
did not result in any changes in the alpha ratings during NREM
sleep. Only 8 patients (36%) exhibited the alpha NREM sleep
anomaly at baseline. Those patients reported more sleep
difficulty, but otherwise were clinically indistinguishable
from those without this EEG sleep anomaly. Lower baseline
alpha NREM sleep ratings were seen in responders to
amitriptyline than in nonresponders, but these differences did
not reach statistical significance.

CONCLUSION. The alpha NREM
sleep anomaly is present in only a small proportion of
patients with fibromyalgia. It does not correlate with disease
severity nor is it affected by treatment with amitriptyline. A
larger sample size will be needed to adequately assess the
value of this sleep anomaly in predicting the response to
amitriptyline.

Carette S, Oakson G, Guimont C, Steriade M




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