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

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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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