Pregabalin associated with improved sleep parameters in people with fibromyalgia, says study

According to new research published in The Clinical Journal of Pain, treating people who have fibromyalgia with pregabalin improved sleep parameters, including decreasing the number of wake/sleep bouts and increasing the length of total sleep duration.

In the past, disordered sleep has been implicated as a contribution to abnormal pain sensation present in fibromyalgia and it has been suggested that improving sleep quantity and quality may reduce the symptoms of pain and fatigue frequently experienced by people with the condition.

For this study, Dr Thomas Roth, and colleagues at the Sleep Disorders and Research Center at the Henry Ford Health System, Detroit, US, analised data from patients enrolled in a multinational, multicenter, placebo-controlled crossover study.

Participants were chosen at random to receive either pregabalin (150 to 450mg per day) or a placebo, for 14 days, followed by two double-blind 14-day crossover treatment periods, each including two-week taper periods between crossover time points.

On two consecutive nights at the time of initial patient screening and at the end of each crossover treatment, polysomnography (PSG) was performed, measuring total sleep time (TST), wake after sleep onset (WASO), latency to persistent sleep (LPS), slow wave sleep (SWS), length of time in sleep stages, and the number and duration of sleep or wake bouts. A subjective assessment of pain was obtained by asking study participants to rate the average pain over the past 24 hours on the numerical rating scale (NRS).

Researchers found that in 86.6% of the patients, who were predominantly female, the number of wake/sleep bouts were significantly decreased in those taking pregabalin compared to the placebo and that the total sleep bout duration was also significantly increased in participants taking pregabalin compared to the placebo.

The researchers concluded in the study that pregabalin treatment was associated with improved sleep parameters in patients with fibromyalgia, including decreased number of wake/sleep bouts and increased total sleep bout duration. They go on to say that this suggests that pregabalin treatment may help improve subjective measures of sleep and fatigue that are frequently associated with increased morbidity in fibromyalgia.

However, the findings were limited because of the short length of the study, which left open the possibility of developing long term tolerance to the drug and also the incident rate of adverse effects of pregabalin in specific patient groups would also have to be considered.

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