Sleep problems are associated with an increased risk of fibromyalgia syndrome (FMS) in women. The risk of FMS increases with the severity of sleep problems, and the association is stronger in middle-aged and older women than in younger women.

In a prospective study, Mork and Nilsen investigated the effect of sleep problems on FMS risk in a population of women in Norway. They included patients aged 20 years and older who had participated in the Nord-Trøndelag Health study, a large population-based trial, by answering a health-related questionnaire and undergoing clinical examination. For the current study, the researchers selected 12,350 women who were free of musculoskeletal pain and movement disorders.

At follow-up, 327 women had fibromyalgia, representing an incidence proportion of 2.6% during 10 years. The adjusted relative risk for women who reported having sleep problems "often" or "always" was 5.41 among women older than 45 years and 2.98 among those between 20 and 44 years.

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The severity of fibromyalgia syndrome (FMS) symptoms—with generally continuing high levels of self-reported symptoms and distress for most patients—does not show clinically meaningful improvement over time. However, up to about 25% of patients report at least moderate improvement.

Walitt and associates conducted a longitudinal study to assess 1555 patients who had a diagnosis of FMS from US rheumatologists. All patients completed 2 or more semiannual questionnaires. Physical component summary and mental component summary scores were calculated. Change in FMS symptom severity was assessed by comparing data at the first and last observations over a mean study duration of 4 years.

The mean FMS severity score was 22.7 at study onset and had an estimated 5-year improvement of 1.8 units. The 5-year improvement for pain, fatigue, and sleep was 0.4 units; there was no improvement in patient global severity. At the last observation, about 10% of patients had a substantial response, about 14% had a moderate response, and about 54% had no response. Overall, FMS severity worsened in 35.9% of patients and pain in 38.6%.

The authors noted that their data provide clinicians and patients with realistic expectations on the course of FMS in routine clinical care.

Change in FMS symptom severity was assessed by comparing data at the first and last observations over a mean study duration of 4 years.