A recent flurry of important studies has provided critical new information that is relevant to the contemporary understanding of the fibromyalgia syndrome. The concept that these patients represent solely a form of masked depression or a distinctive syndrome of somatization is not supported by the current facts. Rather it would appear that a characteristic peripheral nociceptive component is modulated by an interplay of complex central factors. A disruption of the neuroendocrine axis controlling growth hormone production may be the link between disturbed sleep and muscle pain, as growth hormone is produced predominantly during stage four sleep. A paradigm to link some of these newer findings is presented.