Fibromyalgia & Chronic Pain LIFE Spring 2015, Issue 11 | Page 12
Research Update
function of NREM
and lead to the development of FM
symptoms.
They
proposed that the
FM symptom complex should be
considered a “nonrestorative
sleep
syndrome.” The results of their study
supported the hypothesis that a disorder of serotonin metabolism serves as a basis for both the
EEG sleep disturbance and FM.
D
ecades have passed since Dr.
Moldofsky’s original work,
and the debate continues regarding whether FM is caused by some
kind of sleep disturbance. Many
new scientific discoveries have
been made involving sleep and
its significance in preserving and
instilling good health. Dr. Victor Rosenfeld, a neurologist and
sleep expert from the SouthCoast
Health in Savannah, Georgia published an article in the September
2014 Journal of Neurophysiology
entitled “Polysomnography with
Quatititative EEG in Patients with
and without Fibromyalgia.”
I
n essence, Dr. Rosenfeld replicated Dr. Moldofsky’s work using a newer technique called quantitative electroencephelopgraphy
(qEEG), which essentially allows computerized analysis of the deep
sleep disruptions called
alpha intrusions, as opposed to the painstaking analysis by Moldofsky which was done by
hand. In addition, Dr
Rosenfeld discovered a
high prevalence of obstructive sleep apnea in
his FM study subjects.
12 Fibromyalgia & Chronic Pain
Life
O
bstructive sleep apnea impacts
autonomic arousal which is
mediated by the autonomic nervous system (ANS). The ANS which
acts unconsciously and regulates
heart rate, digestion, respiratory
rate, papillary response, urination
and sexual arousal, and is the primary mechanism in control of the
fight-or-flight response. This significant finding is now being reported in recent studies around the
globe in patients with FM.
P
olysomnography (PSG) is a
comprehensive recording of
the biophysiological changes that
occur during sleep. It is usually
performed at night during sleep
in a special laboratory, sometimes
utilizing a hotel room type setting in order to help patients feel
at ease and better able to sleep in
a foreign environment. The PSG
monitors many body functions
including brain EEG, eye movements, muscle activity, snoring,
EKG, during sleep. Since sleep
apnea was identified in the 1970s,
breathing functions respiratory
airflow and respiratory effort indicators have been added along
with peripheral pulse oximetry,
the measurement of oxygen saturation of the blood.
D
r. Rosenfeld’s study objective
was to characterize the polysomnographic and quantitative
electroencephalographic (qEEG) features of FM and determine if patients
differ in these measures when compared
to a control group
of sleep disorder patients.
The study was performed at a community-based sleep medicine center, and the
Sp r i n g 2 0 1 5
patients underwent polysomnography over a two-year period. The research subjects underwent all-night
polysomnography for evaluation of
a sleep disorder and FM. The resulting polysomnograms w