Daytime napping associated with increased symptom severity in fibromyalgia syndrome.

Alice Theadom,Mark Cropley,Thomas Kantermann

doi:10.1186/s12891-015-0464-y

Abstract

BackgroundPrevious qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Yet there is no evidence to suggest whether daytime napping is beneficial or detrimental for people with fibromyalgia. The purpose of this study was to explore how people use daytime naps and to determine the links between daytime napping and symptom severity in fibromyalgia syndrome.MethodsA community based sample of 1044 adults who had been diagnosed with fibromyalgia syndrome by a clinician completed an online questionnaire. Associations between napping behavior, sleep quality and fibromyalgia symptoms were explored using Spearman correlations, with possible predictors of napping behaviour entered into a logistic regression model. Differences between participants who napped on a daily basis and those who napped less regularly, as well as nap duration were explored.ResultsDaytime napping was significantly associated with increased pain, depression, anxiety, fatigue, memory difficulties and sleep problems. Sleep problems and fatigue explained the greatest amount of variance in napping behaviour, p < 0.010. Those who engaged in daytime naps for >30 minutes had higher memory difficulties (t = −3.45) and levels of depression (t = −2.50) than those who napped for shorter periods (<30mins) (p < 0.010).ConclusionsFrequent use and longer duration of daytime napping was linked with greater symptom severity in people with fibromyalgia. Given the common use of daytime napping in people with fibromyalgia evidence based guidelines on the use of daytime napping in people with chronic pain are urgently needed.

Highlights

Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice
Four percent of the sample were excluded from the analysis because they completed less than 80% of items on one or more of the measures
Due to the wide range of co-morbidities reported, participants were classified as having no co-morbidity (N = 203), 2 or less comorbidities (N = 548) or >2 co-morbidities (N = 293)

Summary

Introduction

Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Underlying circadian processes have been found to influence the benefits achieved following a nap, with the greatest restorative effects revealed if naps are taken on a regular basis in the afternoon when the most severe sleepiness and pressure for sleep is likely to occur [10,17]. It appears that the duration of naps and the time of day people engage in a daytime nap is linked to its effects

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