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The following is a summary of “Treatments for enhancing sleep quality in fibromyalgia: a systematic review and meta-analysis,” published in the March 2025 issue of Rheumatology by Pathak et al. 

Sleep disturbance is a core symptom of fibromyalgia and a risk factor for widespread pain. 

Researchers conducted a prospective study to assess the effectiveness of pharmacological treatments and cognitive behavioral therapy (CBT) in improving sleep quality in patients with fibromyalgia.  

They searched PubMed, MEDLINE, Embase, Cochrane CENTRAL, and CINAHL for randomized controlled trials (RCTs) published up to April 2023. Studies on pharmacological or CBT interventions with sleep-related outcomes were included. Data were extracted, and meta-analyses were performed where applicable. Study quality and bias were assessed using the Cochrane Risk of Bias tool. 

The results showed that 47 RCTs with 11,094 participants were reviewed. CBT for insomnia (CBT-I) significantly improved sleep quality (SMD -0.63, 95% CI -0.98 to -0.27), while CBT for pain (CBT-P) had no effect. Pregabalin and sodium oxybate moderately improved sleep but with uncertainty. Amitriptyline, milnacipran, and duloxetine showed no benefit. Study heterogeneity was moderate, with no publication bias. 

Investigators found CBT-I effective for improving sleep in fibromyalgia, while pregabalin showed potential but required caution. Future trials should prioritize sleep outcomes and compare treatments to guide therapy. 

Source: academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaf147/8078619