upright=1.67 The defining symptoms of<unk>  are chronic widespread pain, fatigue, and sleep disturbance. Other symptoms may include heightened pain in response to tactile pressure (allodynia), cognitive problems, musculoskeletal stiffness, environmental sensitivity, hypervigilance, sexual dysfunction, and visual symptoms. Pain<unk>  is predominantly a chronic pain disorder. According to the NHS, widespread pain is one major symptom, which could feel like: an ache, a burning sensation, or a sharp, stabbing pain. Fatigue Fatigue is one of the defining symptoms of<unk> . Patients may suffer from physical or mental fatigue. Physical fatigue can be demonstrated by a feeling of exhaustion after exercise or by a limitation in daily activities. Due to the predominance of fatigue,<unk>  bears a similarity to chronic fatigue syndrome. Sleep problems Sleep problems are a core symptom in<unk> . These include a difficulty to fall asleep or stay asleep, awakening while sleeping and waking up feeling unrefreshed. A meta-analysis compared objective and subjective sleep metrics in people with<unk>  and healthy people. Individuals with<unk>  had lower sleep quality and efficiency, as well as longer wake time after sleep start, shorter sleep duration, lighter sleep, and greater trouble initiating sleep when objectively assessed, and more difficulty initiating sleep when subjectively assessed. Cognitive problems Many people with<unk>  experience cognitive problems (known as "fibrofog" or "brainfog"). One study found that approximately 50% of<unk>  patients suffered from subjective cognitive dysfunction and that it was associated with higher levels of pain and other<unk>  symptoms. The American Pain Society recognizes these problems as a major feature of<unk> , characterized by trouble concentrating, forgetfulness and disorganized or slow thinking. Studies have shown that<unk>  patients exhibit problems with short- and long-term memory, short-term memory consolidation, working memory, impaired speed of performance, inability to multi-task, cognitive overload, and diminished attention span. About 75% of<unk>  patients report significant problems with concentration, memory, and multitasking. A 2018 meta-analysis found that the largest differences between<unk>  patients and healthy subjects were for inhibitory control, memory, and processing speed. It is hypothesized that the increased pain compromises attention systems, resulting in cognitive problems. Hypersensitivity In addition to a hypersensitivity to pain, patients with<unk>  show hypersensitivity to other stimuli, such as bright lights, loud noises, perfumes and cold. A review article found that they have a lower cold pain threshold. Other studies documented an acoustic hypersensitivity.
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