Juvenile fibromyalgia (FM): clinical & polysomnographic aspects

OBJECTIVE: To identify the child-mother diagnostic correlation in
fibromyalgia (FM), to study sleep disturbance in juvenile FM,
and to compare clinical aspects and sleep disorders between
these groups.

METHODS: We studied 34 children with confirmed
FM aged 11 +/- 1 years, 10 children with diffuse pain, and 17
age and sex matched asymptomatic controls. The respective 61
mothers were included: 34 asymptomatic and 27 with FM. All
participants were subjected to clinical evaluation, a sleep
questionnaire, and nocturnal polysomnography, preceded by a
night of adaptation. Sleep scoring was done visually and a
computerized analysis was performed for alpha, theta, and
delta waves in slow wave sleep (SWS).

RESULTS: A significant
predominance of mothers with FM was observed in the group of
children with FM (71%) compared to children with diffuse pain
(30%) and asymptomatic children (0%). According to the sleep
questionnaire, the complaints of superficial sleep and
nonrestorative sleep were more prominent in mothers with FM
than in children with FM, whereas motor agitation during
sleep was more frequent in the children with FM.

Polysomnographic anomalies were also more prominent in mothers
with FM than in children with FM in terms of decrease in
sleep efficiency, increase of number of arousals during
sleep, and alpha intrusion in SWS. Both FM groups presented
an increased alpha + theta time/delta time index during SWS
compared to respective controls, and mothers with FM also
showed an increase in alpha time/delta time index during SWS,
compared to asymptomatic mothers. A correlation was found
between alpha + theta time/delta time index during SWS and
intensity of clinical manifestations of pain and sleep
anomalies in children and their mothers.

Significant concordance was observed regarding FM diagnosis
in children and their mothers. Sleep complaints and
polysomnography findings were less prominent in affected
children compared to mothers with FM. In addition, we
observed a significant correlation between polysomnographic
indexes, sleep anomalies, and pain manifestations in children
and their mothers.

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