2025 — FM sleep interventions: Cochrane-style network meta-analysis (168 RCTs)
One-paragraph summary
Cochrane-methodology systematic review and network meta-analysis of 168 randomized controlled trials of pharmacologic and nonpharmacologic interventions for sleep problems in fibromyalgia. Primary outcome: sleep quality (validated patient-reported measures). The NMA evaluates 35 treatment categories across 8,247 participants. Cochrane Risk-of-Bias tool used; most studies at high overall RoB. Evidence (some) that land-based aerobic exercise training combined with flexibility training reduces sleep problems (SMD reported). For the project, this is the definitive evidence-base anchor for sleep-targeted FM therapies — closes the long-dormant B5 bridge (glymphatic + sleep + neuroinflammation) with rigorous quantitative evidence synthesis. Establishes which interventions in the existing FM-sleep-therapy space actually have evidence.
Claims as triples
sleep_architecture_disruption — modulates → fm_central_only[evidence: 168-RCT NMA across 35 treatment categories; confidence: established]exercise — modulates → sleep_architecture_disruption[evidence: NMA finding for land-based aerobic + flexibility; confidence: emerging]
Triangulation notes
- The most rigorous evidence-base anchor for FM sleep interventions in the project's evidence base. Promotes the project's sleep-axis understanding from B5 bridge candidate to evidence-grounded therapy-class framework.
- Adds discipline to the cure-path-arm program — any future sleep-targeted arm needs to be compared against this NMA's already-evaluated 35 treatment categories before adding novel ones.
- Discovered via Probe 4 (HBOT); the NMA covers HBOT alongside 34 other intervention categories. Scored ingestion-worthy; promoted in Recommendation 3.
Open questions raised
- Which of the 35 treatment categories show consistent FIQ-R or pain-intensity effects beyond sleep specifically? Could inform v0.4 cure-path program priority ordering.
- Where do the project's own cure-path arms (resveratrol, metformin, green-light, FcRn blockade) sit in the NMA's framework — has any of them been tested for FM-sleep endpoints specifically?