Symptom Severity Increase Seen With Napping in Fibromyalgia

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Napping Linked to Increased Symptom Severity in Fibromyalgia
Napping Linked to Increased Symptom Severity in Fibromyalgia

Frequent daytime napping is associated with greater symptom severity in people with fibromyalgia, confirming the previous notion that those with fibromyalgia nap in order to cope with the condition.

Still, there is no evidence that suggests napping is beneficial or detrimental for people with the condition.

Alice Theadom, PhD, of Auckland University of Technology in New Zealand, and colleagues surveyed 1,044 adults (92.5% female) diagnosed with fibromyalgia via an online questionnaire to determine how nap frequency and duration correlated with fibromyalgia symptoms.

Participants had a high rate of comorbid conditions, including arthritis (20%), irritable bowel syndrome (15%), asthma (13%), psychiatric condition (5.1%), and depression (11.2%). A large number of participants were also taking medication for their fibromyalgia symptoms, including opioids, NSAIDS, and tricyclic antidepressants.

Of participants who napped on a daily basis, 18.9% napped in the morning, 58.8% napped in the afternoon, and 25% napped in the evening, with the majority (86.5%) napping unintentionally. The most common reasons for napping included tiredness/exhaustion (94.1%), not feeling well (67.2%), catching up on the previous night's poor sleep (59.6%), headache (42.6%), and pain (26.2%). Notably, younger participants took more daytime naps than participants over age 60, and also napped for longer periods of time.

The researchers found that daytime napping was significantly positively associated with number of comorbidities, level of fatigue, pain, anxiety, depression, sleep problems, and memory difficulties (P<0.01). Daytime napping was also associated with the use of serotonin-norepinephrine reuptake inhibitors or selective serotonin reuptake inhibitors, Pregabalin or Gabapentin, and opioids.

In terms of frequency and duration, those who took frequent daytime naps had more comorbidities, pain, fatigue, memory problems, sleep problems, anxiety, and depression compared to those who napped less frequently or not at all. Those who napped daily for longer than 30 minutes tended to be younger in age, had children living at home, and had higher levels of depression and memory problems compared to those who napped for less than 30 minutes per day.

“It was interesting that in this study, age was not found to be positively associated or predictive of daytime napping behavior in FMS, even with 11.5% of the sample aged over 60 years. Moreover, it was observed that younger adults with FMS napped more frequently and for longer periods of time than older adults; with a higher proportion of younger adults reporting napping due to pain and irritability,” the researchers wrote. “These findings suggest that napping behavior may be more intrinsically linked to FMS symptoms than other demographic factors, however causality was unable to be determined within this study.”

Noting inconsistencies in advice given to patients from clinicians about napping, the researchers stressed that more research is needed to determine if daytime napping is beneficial or detrimental to fibromyalgia symptoms. 

Reference

  1. Theadom A et al. BMC Musculoskelet Disord. 2015; doi:10.1186/s12891-015-0464-y. 
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