Comorbid Insomnia Exacerbates Fibromyalgia Brain Changes

“It used to be thought that if you had a chronic pain condition and sleep problems, the sleep problems were just part of the pain condition. Now there is thinking that not only are the conditions reciprocal, but there is a strong interest in the idea that if you can directly treat the sleep you might see some impact on pain,” Dr. McCrae pointed out.

“We know that there is disrupted brain activity and that the disruption is worse for people with a comorbid diagnosis. We don’t have a specific targeted treatment to hand off to clinicians yet — that is what we are currently researching. What we do know is that if you combine your treatments it is best to be mindful of both disorders and try to address both in your treatment rather than focus on one or the other,” Dr. Craggs concurred.

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Future research is planned to determine the impact of cognitive behavioral therapy on disrupted areas of the brain in patients with insomnia and chronic pain conditions.

“The ultimate goal of our work is to look at the impact of different treatments — alone and possibly combined — on what is happening within the brains of these patients, because our overarching hypothesis is that chronic pain and insomnia share a common underlying nervous system mechanism,” Dr. McCrae concluded.


Vatthauer KE, Craggs JG, Robinson ME. Sleep is associated with task-negative brain activity in fibromyalgia participants with comorbid chronic insomnia. J Pain Res. 2015 Nov 12;8:819-27. doi: 10.2147/JPR.S87501. eCollection 2015.