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Holman AJ – This review attempts to demystify the FM presentation and outline a pragmatic three–step process to redirect analysis of FM signs and symptoms. Understanding the impact of sleep quality on central sensitization and patient presentation is essential. Furthermore, the impact of autonomic dysregulation on sleep quality and its prominence in the multilayered FM clinical presentation will be discussed. Finally discussed is how initial segregation of sleep and autonomic regulatory concerns yield a practical, integrative framework for ultimately analyzing other comorbidities.

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