Abstract
Fibromyalgia (FM) is a prevalent, debilitating condition characterized by widespread, intense pain experienced as emanating
from in the muscles, tendons, and ligaments. Other symptoms include disabling fatigue, poor sleep quality, gastrointestinal
complaints, cognitive difficulties and often depression. Lack of apparent muscle pathology or other obvious physiological
causes of FM pain make the etiology of FM unclear. This manuscript reviews extant FM literature and integrates research on
sleep and the burgeoning literature from the domain of cognitive neuroscience to formulate the Sleep and Pain Diatheses (SAPD)
model of FM. This model proposes that a wide range of biopsychosocial stressors can set the stage for FM by activating diatheses
for sleep disruption and pain sensitivity. Sleep disruption in those most sensitive to pain initiates a cascade of symptoms
that are codified as FM. Once this process is initiated, the symptoms of FM are perpetuated and aggravated by increased vigilance
to a broad range of threat-related biopsychosocial stimuli. Thus, it is proposed that sleep is integral to the etiology of
FM and also energizes a cognitive feedback loop that maintains or amplifies symptom severity over time.
from in the muscles, tendons, and ligaments. Other symptoms include disabling fatigue, poor sleep quality, gastrointestinal
complaints, cognitive difficulties and often depression. Lack of apparent muscle pathology or other obvious physiological
causes of FM pain make the etiology of FM unclear. This manuscript reviews extant FM literature and integrates research on
sleep and the burgeoning literature from the domain of cognitive neuroscience to formulate the Sleep and Pain Diatheses (SAPD)
model of FM. This model proposes that a wide range of biopsychosocial stressors can set the stage for FM by activating diatheses
for sleep disruption and pain sensitivity. Sleep disruption in those most sensitive to pain initiates a cascade of symptoms
that are codified as FM. Once this process is initiated, the symptoms of FM are perpetuated and aggravated by increased vigilance
to a broad range of threat-related biopsychosocial stimuli. Thus, it is proposed that sleep is integral to the etiology of
FM and also energizes a cognitive feedback loop that maintains or amplifies symptom severity over time.
- Content Type Journal Article
- Category Original Article
- Pages 1-13
- DOI 10.1007/s10608-011-9390-y
- Authors
- Nancy A. Hamilton, Department of Psychology, University of Kansas, 1415 Jayhawk Blvd, Lawrence, KS, USA
- Ruth Ann Atchley, Department of Psychology, University of Kansas, 1415 Jayhawk Blvd, Lawrence, KS, USA
- Cynthia W. Karlson, University of Mississippi Medical Center, Jackson, MS, USA
- Daniel Taylor, University of North Texas, Denton, TX, USA
- Danyale McCurdy, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Journal Cognitive Therapy and Research
- Online ISSN 1573-2819
- Print ISSN 0147-5916