{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:57:01Z","timestamp":1792069021024,"version":"4.4.0"},"reference-count":70,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Spanish Ministry of Science and Innovation","award":["PSI2009-13765"],"award-info":[{"award-number":["PSI2009-13765"]}]},{"name":"Spanish Ministry of Science and Innovation","award":["PID2019\u2013109612GB I00\/AEI\/10.13039\/501100011033"],"award-info":[{"award-number":["PID2019\u2013109612GB I00\/AEI\/10.13039\/501100011033"]}]},{"name":"Spanish State Research Agency","award":["PSI2009-13765"],"award-info":[{"award-number":["PSI2009-13765"]}]},{"name":"Spanish State Research Agency","award":["PID2019\u2013109612GB I00\/AEI\/10.13039\/501100011033"],"award-info":[{"award-number":["PID2019\u2013109612GB I00\/AEI\/10.13039\/501100011033"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Objective: fibromyalgia is a complex chronic pain syndrome characterized by widespread musculoskeletal pain, insomnia and autonomic alterations. Cognitive-behavioral therapy (CBT) is regarded as a promising treatment in fibromyalgia, but its impact on autonomic function remains uncertain. In this research, we studied the effect of CBT on autonomic functions in fibromyalgia. Methods: Twenty-five participants underwent overnight polysomnographic recordings before and after CBT programs focused on pain (CBT-P) or a hybrid modality focused on pain and insomnia (CBT-C). Sleep quality, daily pain, depression and anxiety were assessed by self-reported questionnaires. We analyzed heart rate variability (HRV) using high-frequency power (HF) as a marker for parasympathetic activity, and low-frequency power (LF) and the LF\/HF ratio as relative sympathetic markers during wakefulness and at each sleep stage. Results: After treatment, 14 patients (\/25, 58.0%) reported improvement in their sleep: 6 in the CBT-P condition (\/12, 50%), and 8 in the CBT-C condition (\/13, 61.5%). We found that, regardless of the type of CBT, patients who reported improvement in sleep quality (n = 14, 58%) had an increase in HF during stages N2 (p &lt; 0.05) and N3 (p &lt; 0.05). These changes were related to improvement in sleep quality (N2, r = \u22120.43, p = 0.033) but not to pain, depression or anxiety. Conclusions: This study showed an improvement in parasympathetic cardiac control during non-rapid-eye-movement sleep following CBT in fibromyalgia participants who reported better sleep after this therapy. CBT may have a cardio-protective effect and HRV could be used as a sleep monitoring tool in fibromyalgia.<\/jats:p>","DOI":"10.3390\/brainsci12070947","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T11:22:24Z","timestamp":1658316144000},"page":"947","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of Cognitive-Behavioral Therapy on Nocturnal Autonomic Activity in Patients with Fibromyalgia: A Preliminary Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8858-8416","authenticated-orcid":false,"given":"Germ\u00e1n","family":"Prados","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA, 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, 18071 Granada, Spain"},{"name":"Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Pilar","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, 18071 Granada, Spain"},{"name":"Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana I.","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, 18071 Granada, Spain"},{"name":"Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Pichot","sequence":"additional","affiliation":[{"name":"INSERM, U1059, Sainbiose, Dysfonction Vasculaire et H\u00e9mostase, Universit\u00e9 de Lyon, Universit\u00e9 Jean Monnet, 42023 Saint-Etienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Medina-Casado","sequence":"additional","affiliation":[{"name":"Blood Transfusion Centre and Tissue Bank of Granada-Almer\u00eda, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Chouchou","sequence":"additional","affiliation":[{"name":"IRISSE Laboratory (EA4075), UFR SHE, University of La R\u00e9union, 97430 Le Tampon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 Revisions to the 2010\/2011 Fibromyalgia Diagnostic Criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin. 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