0395 Effect Of Cognitive-behavioral Therapy On Nocturnal Autonomic Activity In Patients With Fibromyalgia: A Preliminary Study
Bibliographic record
Abstract
Fibromyalgia is a common and complex chronic pain syndrome, characterized by widespread musculoskeletal pain and insomnia. It is now well established that lack of sleep is a risk factor of cardiovascular mortality. One of the potential mechanisms is the alteration in autonomic control of the cardiovascular system, marked by a diurnal and nocturnal sympathetic predominance. Cognitive behavioral therapy (CBT) is now considered as a promising treatment in fibromyalgia but its impact on autonomic function remains unknown. In this work, we assessed the effect of CBT on autonomic functions in 22 participants with fibromyalgia. These participants underwent one of these two distinct CBT programs: one focused on pain (n=10) and the other on sleep complaints (n=12). Patients also underwent overnight polysomnographic recordings before and after CBT. We analyzed heart rate variability (HRV) before and after CBT and according to the type of CBT programs, using high frequency power (HF) as a marker for parasympathetic activity, low frequency power (LF) and LF/HF ratio as a sympathetic marker during wakefulness and each sleep stage. Subjective sleep quality was assessed by Sleep Quality Assessment Index. We found that, regardless of the type of CBT, patients who reported subjective improvement in their sleep (n=14, 60%), had an increase in HF during stages N2 (p<0.05) and N3 (p<0.05), along with an increase in the duration of these stages (p<0.05), unrelated to changes in psychophysical factors (daily pain, depression, and anxiety reports). This work shows, for the first time, an improvement in parasympathetic function during non-rapid-eye-movement (NREM) sleep following CBT in fibromyalgia participants who improved their sleep after CBT. In 1) CBT focused on pain or sleep may have a cardio-protective effect in patients who suffer from fibromyalgia; 2) HRV monitoring appears to be an objective and relevant tool for monitoring sleep improvement in fibromyalgia following CBT. Further studies are needed to confirm these results and investigate their underlying mechanisms. Support (If Any):
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".