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Abstract Number: 1116

Mindfulness Is Associated with Sleep Quality Among Patients with Fibromyalgia

Yuan Zhang1, Lori Lyn Price2, Nani Morgan3, Lucas Morgan4 and Chenchen Wang5, 1School of Nursing, University of Massachusetts Lowell, Lowell, MA, 2Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, 3Internal Medicine Residency Program, University of Hawaii, Honolulu, HI, 4Clinical Psychology, University of Massachusetts, Honolulu, HI, 5Rheumatology, Tufts Medical Center, Boston, MA

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: depression, fibromyalgia, mindfulness, pain and sleep

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Session Information

Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes: Clinical Focus

Session Type: Abstract Submissions (ACR)

Background/Purpose: Mindfulness is the ability to observe, describe, or be aware of present moment experiences without judgment or reactivity. Previous literature suggests that mindfulness-based interventions may be effective in reducing chronic pain and depression experienced among patients with fibromyalgia. Additionally, fibromyalgia patients commonly experience sleep disturbance, which at least partially attributes to chronic pain and depression. Therefore, we hypothesize that mindfulness could be associated with fibromyalgia patients’ sleep quality, and the effect may be explained through reducing symptoms of chronic pain and depression.  

Methods: We conducted a secondary analysis of baseline data from a randomized controlled trial comparing Tai Chi and aerobic exercise among patients with fibromyalgia. Patients completed the Five Facet Mindfulness Questionnaire (FFMQ), a 39-item, self-report questionnaire; scores ranging 39-195, with higher scores representing higher levels of mindfulness. Participants also completed the Beck Depression Inventory Second Edition (BDI-II), PROMIS Pain Interference, PROMIS Sleep Disturbance, and Pittsburgh Sleep Quality Index (PSQI). Pearson correlations were run to examine the associations of mindfulness with sleep quality and disturbance, chronic pain, and depression. Multivariate linear regressions were run to examine the predicting effect of mindfulness on sleep quality and disturbance. Chronic pain and depression were then separately introduced into the regressions to test their potential mediating effects.

Results: This study included 160 fibromyalgia patients with an average age of 51.9 years, primarily female (92%). Patients reporting higher levels of mindfulness tended to report better sleep quality (r=-0.25, p<0.01) and less sleep disturbance (r=-0.27, p<0.01), as well as lower chronic pain (r=-0.36, p<0.01), and less depression (r=-0.57, p<0.01)). Patients reporting higher levels of chronic pain or depression tended to report worse sleep quality (r=0.42 & r=0.43, p<0.01) and more sleep disturbance (r=0.42 & r=0.32, p<0.01). The linear regression modeling reported that mindfulness significantly predicted sleep quality and disturbance (Table 1). The association between mindfulness and sleep quality/disturbance was partially mediated through chronic pain and depression (Table 1).

Conclusion: Mindfulness may be associated with fibromyalgia patients’ sleep quality, and the effect could possibly be explained through affecting the symptoms of chronic pain and depression. Longitudinal studies are needed to further evaluate whether improvement in mindfulness are associated with improvement in sleep quality of fibromyalgia patients.

Table 1. Linear Regression Models for the Predicting Effect of Mindfulness on Sleep Quality/Disturbance and the Mediating Effect of Chronic Pain and Depression

Independent variables

Sleep quality (PSQI)

Sleep Disturbance (PROMIS)

Model 1

Model 2

Model 3

Model 1

Model 2

Model 3

FFMQ

PROMIS pain

BDI-II

Age

Female

Male

White

Black

Others

Education

-0.045**

–

–

-0.044

0

-1.391

0

-0.722

-2.293**

-0.199

-0.022

0.225**

–

-0.014

0

-1.224

0

-0.271

-2.162**

-0.146

-0.007

–

0.118**

-0.017

0

-0.995

0

-0.608

-2.077*

-0.115

-0.086**

–

–

-0.109*

0

-2.815

0

-1.482

-4.651**

0.160

-0.047

0.423**

–

-0.057

0

-1.460

0

-0.865

-4.651**

0.247

-0.055

–

0.099

-0.091

0

-2.399

0

-1.499

-4.560**

0.246

Note: *p<0.05; **p<0.01. Model 1 explains the predicting effect of mindfulness on sleep quality/disturbance, with adjustment of age, gender, race, and education. Model 2 explains the partial mediating effect of chronic pain on the association between mindfulness and sleep quality/disturbance. Model 3 explains the partial mediating effect of depression on the association between mindfulness and sleep quality/disturbance.

 


Disclosure:

Y. Zhang,
None;

L. L. Price,
None;

N. Morgan,
None;

L. Morgan,
None;

C. Wang,
None.

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