Treating Sleep Disorders
Fibromyalgia can often interfere with a good night’s sleep. Muscle pain, migraines, and the countless other symptoms associated with the illness, make sleep extremely troubled, if not impossible. But if you are finding that you are consistently unrested when you wake up in the mornings, you may be suffering from a sleep disorder that is only adding to your sleep woes. If your sleep disorder is interfering with your life, be sure to seek out appropriate treatment.
Sleep apnea is one of the most common sleep disorders found among fibromyalgia patients. Luckily, there are a variety of sleep apnea treatments available for sufferers.
Continuous Positive Airway Pressure (CPAP)
CPAP is the most commonly used treatment for serious sleep apnea symptoms. CPAP involves wearing a mask over your nose every night when you go to sleep. The mask blows pressurized air into your nostrils, helping to open up your airways. This prevents you from choking during the night. CPAP can be uncomfortable for some people to wear while sleeping, however, when paired with weight loss, CPAP is one of the most effective sleep apnea treatments.
There are various acrylic dental appliances that can aid in solving your apnea troubles. Dental appliances work to reposition your tongue or jaw, helping to reopen your airway while you are sleeping. Most are worn in the jaw or around your face. The Tongue Retraining Device (TRD) works to splint your tongue in place while you sleep, thereby preventing it from falling back into your throat and blocking your airway. The Mandibular Repositioning Device (MRD) works to move your lower jaw forwards, opening up your airway during sleep. Your dentist can recommend a variety of other appliances that may be able to help.
If all other treatments fail to help you, you can resort to surgery to solve your apnea problems. Once the location of the blockage has been determined, you airway can be enlarged to help you breath better. Often, removal of the tonsils or adenoids helps to open the airways. Your surgeon can also clear your airway by removing excess skin from the back of your throat.
Many fibromyalgia syndrome patients suffer from nighttime bruxism. Bruxism causes sufferers to continually clench or grind their teeth, resulting in jaw pain and sleep difficulties. Bruxism treatments generally involves the use of dental orthotics.
Dental orthotics are often used to prevent symptoms of severe bruxism. Dental night guards made from metal and acrylic are inserted into the mouth each night. These guards provide a flat surface for your teeth to clench onto, preventing further tooth or jaw damage. Because they cover the teeth, night guards also help to eliminate tooth grinding.
Restless Leg Syndrome (RLS)
Restless leg syndrome can be a particularly uncomfortable sleep disorder. It can cause sensations of crawling in the legs, and you may feel the intense urge to move your legs periodically throughout the night. Treatment for restless leg syndrome may involve stretching exercises and a change in sleep patterns. Moderate to severe cases may also require one of the following medications:
- Dopaminergic Agents: These medications, including levodopa and carbidopa, are generally the first line of defense against RLS. They are traditionally used to treat Parkinson’s patients, but also help to reduce nighttime leg sensations and induce sleep. Side effects include nausea and vomiting.
- Benzodiazepines: Benzodiazepines work to depress your central nervous system, helping to induce sleep. They are often beneficial for intermittent symptoms of RLS and can help you to get more restful sleep. Benzodiazepines can make sleep apnea worse however, and may causes side effects including habit formation.
- Anticonvulsants: Anticonvulsants, including gabapentin and carbamazepine, can aid in decreasing crawling sensations caused by RLS. However, these medications can cause dizziness, fatigue, and sleepiness.
- Opioids: Opioids are only used for severe cases of RLS. Opioids, including oxycodone and codeine, help to promote sleep and reduce pain. Side effects can include dizziness, vomiting, fatigue, and addiction.
Periodic Limb Movement Disorder (PLMD)
Periodic limb movement disorder can cause you to move your arms or legs repetitively throughout the night. This can really impact upon the quality of your sleep. Periodic limb movement disorder treatment is very similar to that used for RLS and may include:
- Benzodiazepines: Benzodiazepines are the first line of treatment for PLMD. They help to limit muscle contractions as well as induce sleep. The most commonly used type of benzodiazepine is clonazepine, which has been shown to greatly reduce the number of limb movements per hour.
- Anticonvulsants: Anticonvulsants help to reduce the number of muscle contractions that you experience throughout the night. The most effective anticonvulsant for PLMD is gabapentin.
- GABA Agonists: GABA agonists work to suppress muscle contractions by inhibiting the release of certain neurotransmitters in the brain. The most-commonly used GABA agonist for PLMD is baclofen. Side effects may include drowsiness, fatigue, and headache.