Impact of Sleep Disturbances Treatment in Patients With Fibromyalgia: A Scoping Review.

Abstract

Fibromyalgia (FM) is a chronic clinical syndrome characterised by widespread musculoskeletal pain, fatigue and sleep disturbances, with non-restorative sleep being a central symptom that severely exacerbates the condition. Although management is multidisciplinary, the role of interventions specifically directed at sleep as a primary pathway to improve core FM symptoms requires systematisation. The objective of this scoping review was to map the therapeutic approaches, both pharmacological and non-pharmacological, that address sleep disturbances in FM patients, identifying their characteristics, outcomes and evidence gaps. The review was conducted in accordance with the JBI and PRISMA-ScR guidelines. The search, restricted to articles published between 2020 and 2024, was performed in the PubMed, SciELO and ScienceDirect databases, utilising descriptors such as 'fibromyalgia', 'sleep disorders' and 'therapeutics'. Nine studies met the inclusion criteria (six non-pharmacological, three pharmacological). Non-pharmacological interventions (including diet, manual therapies, and biofeedback) showed mixed results, often without a significant impact on primary sleep outcomes. Repetitive Transcranial Magnetic Stimulation (rTMS) and the drug Suvorexant stood out as the most promising strategies, demonstrating statistically significant improvement in both sleep quality (objective and subjective measures) and core FM symptoms. The field of study is characterised by high heterogeneity in interventions and outcomes, underscoring the need for high-quality Randomised Controlled Trials that utilise objective sleep measures as primary outcomes to provide robust evidence. The mapping provided by this review guides future research in optimising sleep treatment, a critical factor in managing FM and improving patients' quality of life.