Sleep and periodic limb movement in sleep in juvenile fibromyalgia

Objectives. Fibromyalgia has been recently recognized in children and adole scents as juvenile fibromyalgia (JF). In adult fibromyalgia, subjective com plaints of nonrestorative sleep and fatigue are supported by altered polyso mnographic findings including a primary sleep disorder known as periodic li mb movements in sleep (PLMS) in some subjects. Although poor sleep is a dia gnostic criterion for JF, few reports in the literature have evaluated spec ific sleep disturbances. Our objectives were to evaluate in a controlled st udy the polysomnographic findings of children and adolescents with JF for a lterations in sleep architecture as well as possible PLMS not previously no ted in this age group. Methods. Sixteen consecutive children and adolescents (15.0 +/- 2.6 years o f age) diagnosed with JF underwent overnight polysomnography. Polysomnograp hy was also performed on 14 controls (14.0 +/- 2.2 years of age) with no hi story of an underlying medical condition that could impact on sleep archite cture. Respiratory variables, sleep stages, and limb movements were measure d during sleep in all subjects. Results. TF subjects differed significantly from controls in sleep architec ture. TF subjects presented with prolonged sleep latency, shortened total s leep time, decreased sleep efficiency, and increased wakefulness during sle ep. In addition, JF subjects exhibited excessive movement activity during s leep. Six of the JF subjects (38%) were noted to have an abnormally elevate d PLMS index (>5/hour), indicating PLMS in these subjects. Conclusion. Our study demonstrated abnormalities in sleep architecture in c hildren with JF. We also noted PLMS in a significant number of subjects. Th is has not been reported previously in children with this disorder. We reco mmend that children who are evaluated for JF undergo polysomnography includ ing PLMS assessment.