Fatigue and fibromyalgia are basically synonymous. The biggest reason for the fatigue is the poor quality sleep most people with fibromyalgia experience. Another facet of poor quality sleep for FMS sufferers has to do with abnormal sleep breathing, especially sleep apnea, which is considered by some to be a cause of FMS. Conversely, FMS can potentially increase the risk of sleep apnea in those who don’t already have the condition. It’s another case of “what came first …”
Although there doesn’t seem to be an answer yet for why people with FMS tend to have sleep apnea, the fact FMS symptoms get worse with lack of sleep means that treating the situation effectively is very important.
What is Sleep Apnea?
When a person has sleep apnea they stop breathing while sleeping. The condition is more frequent in adults than children, and it seems to be common for people with FMS. According to MedicineNet.com, an apnea is a period of time during which breathing stops or is markedly reduced. It is further defined, simply, as when a person stops breathing for ten second or more. Either complete cessation of breathing or only taking 25% of a normal breath for a period of time that lasts ten seconds or longer is called apnea. This definition includes complete stoppage of airflow and includes at least a 4% drop in blood oxygen levels that result from the stoppage of breathing.
What Happens in Sleep Apnea?
Apneas usually happen when a person is sleeping, often in a deep level of sleep. They are either wakened completely or enough to move into a lighter level of sleep. The sleep disturbance is caused by insufficient breathing or low blood oxygen levels. It is not uncommon for an apnea to happen every few minutes, which of course makes for a very rough night with little sleep – something that exacerbates fibromyalgia symptoms.
Hypopnea is not as severe as apnea, but it too is a decrease in breathing. It is defined as between 69% and 26% of a normal breath with the same 4% or greater drop or in blood oxygen. They, too, disturb sleep and have the same effect upon FMS that apnea has. Sleep apnea and hypopnea is formally defined as having 15 episodes in an hour. That would be the equivalent of one every four minutes. This condition can result in some very serious health problems, including death. They are:
· high blood pressure
· daytime sleepiness
· heartburn and reflux
· erectile dysfunction
· congestive heart failure due to the low flow of blood to the hear
· sleep apnea also affects mood disorders and contributes to insomnia
· sudden death
There are three types of sleep apnea:
1. Central sleep apnea (CSA) – happens when the brain fails to send the message to the muscles breathe
2. Obstructive sleep apnea (OSA) – the brain sends the message, the muscles try to breathe but can’t because of an obstruction that limits air flow
3. Mixed sleep apnea – a combination of the two, CSA and OSA
The most common type of sleep apnea is obstructive sleep apnea (OSA), in which one or more sites in the air passages are blocked by excess tissue in the passages, or a large tongue or tonsils. Another factor in sleep apnea is obesity – something people with FMS have to contend with regularly.
How is FMS Sleep Apnea Treated?
The most successful and common treatment for treating OSA is by use of a machine that provides continuous positive airway pressure, or CPAP. The continuous pressure asserted by the machine keeps airways open so breathing isn’t disturbed at night. The machine is custom programmed for the individual and it comes with a mask to be worn at night that is fitted to the person’s face.
People with FMS may have difficulty wearing the CPAP mask due to hypersensitivity pain in the head or face, or TMJ pain. It can also make it more difficult to fall asleep. However, if it is possible to persevere and get used to it, the CPAP can make a big difference in the quality of sleep obtained. This, in turn makes a big difference in the quality of life a person with FMS can live. Pain levels are lowered, moods levels out and life gets better with some quality sleep.
If the CPAP mask is unbearable, there are some other methods to address sleep apnea that include:
· Weight loss
· Use of a dental device if testing shows that the problem is an obstruction caused by the jaw being out of line
· Surgery – this can be a difficult one for those with FMS because surgery makes symptoms worse, healing takes longer, and apnea and anesthetic is a bad combination
As we said earlier, sleep apnea and FMS is a tough combo. However, with proper medical care and self care, the symptoms of sleep disorders can be managed.