Evidence map›Paper›PMID 40084994›Full record

SynthesisRheumatology (Oxford, England)2025

Treatments for enhancing sleep quality in fibromyalgia: a systematic review and meta-analysis.

Anna Pathak, Eoin M Kelleher, Isabelle Brennan, Raj Amarnani, Amanda Wall, Robert Murphy, Hopin Lee, Beth Fordham, Anushka Irani

Registry-linked trialAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07465991 (Characterisation of Pain in Patients With Musculoskeletal Disease), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07465991 narecruitingnot on this mapstarted 2026, after this paper: background citation

Characterisation of Pain in Patients With Musculoskeletal Disease: a Prospective, Longitudinal, Observational Study With an Embedded Feasibility Window of Opportunity Sleep Study

TypeinterventionalSponsorUniversity of OxfordRan2026 to 2027Enrolled142ConditionsFibromyalgiaArmsDigital Cognitive Behavioural Therapy for Insomnia, Sleep Hygiene Education Materials
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Review
  5. Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Anna PathakDepartment of Medical Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-3672-8290
Eoin M KelleherWellcome Centre for Integrative Neuroimaging, FMRIB Building, John Radcliffe Hospital, Oxford, UK.ORCID 0000-0003-2025-5556
Isabelle BrennanSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Raj AmarnaniRheumatology Department, University College London Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-2982-1756
Amanda WallWellcome Centre for Integrative Neuroimaging, FMRIB Building, John Radcliffe Hospital, Oxford, UK.ORCID 0000-0002-3175-664X
Robert MurphyDepartment of Medical Sciences, University of Oxford, Oxford, UK.ORCID 0009-0008-2754-7387
Hopin LeeOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-5692-0314
Beth FordhamOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-5996-3563
Anushka IraniOxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-7831-4208

Funding

BMA FoundationMRCNIHR
6 · The paper itself

Abstract

objectivesSleep disturbance is a key symptom of fibromyalgia and a risk factor for chronic widespread pain. This systematic review and meta-analysis aims to assess the effectiveness of pharmacological treatments and cognitive behavioural therapy (CBT) in improving sleep quality in fibromyalgia patients.

methodsA systematic search of PubMed, MEDLINE, Embase, Cochrane CENTRAL and CINAHL was conducted for randomized controlled trials (RCTs) published up to April 2023. Studies assessing 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 evaluated using the Cochrane Risk of Bias tool.

resultsForty-seven RCTs, including 11 094 participants, were reviewed. CBT for insomnia (CBT-I) showed a significant improvement in sleep quality (SMD -0.63, 95% CI -0.98 to -0.27), while CBT for pain (CBT-P) had no significant impact. Pharmacological agents such as pregabalin and sodium oxybate moderately improved sleep, but there was uncertainty around this evidence. Amitriptyline, milnacipran and duloxetine showed no significant benefit for sleep. Study heterogeneity was moderate, and no publication bias was detected.

conclusionCBT-I is a promising treatment for enhancing sleep quality in fibromyalgia. Pharmacological treatments like pregabalin may be beneficial but should be used cautiously due to potential risks. Future research should prioritize trials focusing on sleep as a primary outcome and explore the comparative effectiveness of pharmacological treatments and CBT-I in fibromyalgia. Understanding the mechanisms linking sleep and fibromyalgia will also help guide future therapies.

Indexed as

Cognitive Behavioral TherapyFibromyalgiaSleep Initiation and Maintenance DisordersSleep QualitySleep Wake DisordersHumansRandomized Controlled Trials as Topiccognitive behavioural therapyfibromyalgiapharmacological therapiessleep

Identifiers

PMID40084994
PMCPMC12316380

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.