Fibromyalgia: the role of sleep in affect and in negative event reactivity and recovery

OBJECTIVE: Fibromyalgia (FM) syndrome is a chronic pain condition characterized by diffuse muscle pain, increased negative mood, and sleep disturbance. Until recently, sleep disturbance in persons with FM has been modeled as the result of the disease process or its associated pain. The current study examined sleep disturbance (i.e., sleep duration and sleep quality) as a predictor of daily affect, stress reactivity, and stress recovery. DESIGN AND MEASURES: A hybrid of daily diary and ecological momentary assessment methodology was used to evaluate the psychosocial functioning of 89 women with FM. Participants recorded numeric ratings of pain, fatigue, and positive and negative affect 3 times throughout the day for 30 consecutive days. At the end of each day, participants completed daily diary records of positive and negative life events. In addition, participants reported on their sleep duration and sleep quality each morning. RESULTS: After accounting for the effects of positive events, negative events, and pain on daily affect scores, it was found that sleep duration and quality were prospectively related to affect and fatigue. Furthermore, the effects of inadequate sleep on negative affect were cumulative. In addition, an inadequate amount of sleep prevented affective recovery from days with a high number of negative events. CONCLUSIONS: These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning.     

Suicidal Behaviors in Surviving Monozygotic and Dizygotic Co‐Twins: Is the Nature of the Co‐Twin's Cause of Death a Factor?

Genetically informative samples can address hereditary and experiential influences on suicide‐related behaviors. The frequency of suicide‐related behaviors was compared in twins from two survivor groups: (1) those whose co‐twins' deaths were suicides (monozygotic [MZ]: n = 47; dizygotic [DZ]: n = 31), and (2) those whose co‐twins' deaths were nonsuicides (MZ: n = 347; DZ: n = 170). The frequency of suicide attempts among suicide survivors was significantly higher in MZ than DZ twins, while the frequency of suicide attempts among nonsuicide twin survivors did not differ between MZ and DZ twins. Twin concordance for suicide attempts more likely reflects a genetic predisposition than a behavioral reaction to the loss.