This pilot, randomized controlled trial analyzed the effects of a cognitive behavioral therapy (CBT, n = 20) for insomnia vs a sleep hygiene (SH, n = 20) program on the three attentional networks (alertness, orienting, and executive function) and other additional outcome measures (sleep, pain, depression, anxiety, and daily functioning) of fibromyalgia patients. The CBT group showed significant improvement in alertness (F(1, 28) = 11.84, p = .0018), executive functioning (F(1, 28) = 15.76, p = .00059), sleep quality ( F(1, 38) = 6.33, p = .016), and a trend to improvement in daily functioning (p > .06), as compared with the SH group. The improvement in executive functioning was significantly related to the changes in sleep (r = 0.40, p = .026). A CBT for insomnia represents a useful intervention in fibromyalgia patients not only regarding sleep disturbance but also attentional dysfunction and probably daily functioning.

Cognitive complaints are common among subjects with fibromyalgia (FM). Yet, few studies have been able to document these deficits with cognitive tasks. A main limitation of existing studies is that attention has been broadly defined and the tasks used to measure attention are not designed to cover all the main components of the attentional system. Research on attention has identified three primary functions of attention, known as alerting, orienting and executive functioning. This study used the attentional network test-interactions task to explore whether and which of the three attentional networks are altered in FM. Results showed that FM patients have impaired executive control (greater interference), reduced vigilance (slower overall reaction time) and greater alertness (higher reduction in errors after a warning cue). Vigilance and alertness showed several relations with depression, anxiety and sleep quality. Sleep dysfunction was a significant predictor for alertness, whereas there were no significant predictors for vigilance. These findings highlight that the treatment of sleep difficulties in FM patients may help with some of their cognitive complaints.

Fibromyalgia (FM) is a chronic syndrome characterized by heterogeneous clinical manifestations, and knowing this variability can help to develop tailored treatments. To understand better the heterogeneity of FM the present cross-sectional study analyzed the role of several physical symptoms (pain, fatigue and poor sleep quality) and cognitive-affective variables related to pain (pain catastrophizing, pain vigilance, self-efficacy in pain management, and pain acceptance) in the configuration of clinical profiles. A sample of 161 women with FM fulfilled an interview and several self-report measures to explore physical symptoms, cognitive-affective variables, disability and psychopathology. To establish FM groups a hierarchical cluster analysis was performed. The findings revealed three clusters that differed in the grouping variables, Wilks’ λ = .17,F(14, 304) = 31.50,p< .001, η_p²= .59. Group 1 (n= 72) was characterized by high physical and psychological affectation, Group 2 (n= 19) by low physical affectation and high pain self-efficacy, and Group 3 (n= 70) by moderate physical affectation and low pain catastrophizing. The external validation of the clusters was confirmed, Wilks’ λ = .72,F(4, 314) = 14.09,p< .001, η_p²= .15, showing Group 1 the highest levels of FM impact and psychopathological distress. Considering the distinctive clinical characteristics of each subgroup therapeutic strategies addressed to the specific needs of each group were suggested. Assessing FM profiles may be key for a better understanding and approach of this syndrome.

Objectives: This study analyzed sleep quality in fibromyalgia (FM) and systemic lupus erythematosus (SLE) and explored its relationship with other clinical and psychological manifestations. Methods: 20 women with FM, 19 women with SLE and 22 healthy women participated in the study. Subjective sleep quality, fatigue, pain, depression and anxiety were evaluated with self-reports, and objective sleep measures were obtained with actigraphy. Comparisons were analyzed with Chi-square, Kruskal-Wallis H and Mann-Whitney U tests. Relationships between measurements were analyzed with Spearman correlation coefficients. Results: Subjective sleep quality was altered in the FM and SLE groups compared to the control group (15.53 ± 3.27, 8.47 ± 3.20, 4.91 ± 2.79, p < 0.05, respectively). FM and SLE patients reported higher levels of pain (22.65 ± 9.87, 10.21 ± 9.93, 2.30 ± 3.096, p < 0.05), fatigue (4.67 ± 0.37, 3.59 ± 3.04, 2.33 ± 0.59, p < 0.05) and depressive symptoms (9.90 ± 3.78, 4.53 ± 3.04, 4.17 ± 3.95, p < 0.05) than controls, respectively. Worse subjective quality of sleep was associated with higher pain intensity and more depressive symptoms in FM and SLE. Actigraphy measures showed that FM patients spent more time in bed than subjects in the remaining groups. Conclusions: Sleep deterioration is related to more pain and depressive symptoms in FM and SLE. Addressing sleep disturbances may improve not only sleep quality but also depressive symptoms and pain.