Fibromyalgia and Sleep Quality

Side Effect or Cause of Fibro?

Lack of sleep, restless sleep, frequent awakenings and the resulting fatigue are common complaints among individuals suffering from fibromyalgia. Yet while some scientists claim that insomnia and other sleep disorders (i.e., sleep apnea and restless legs syndrome) are the side effects of the constant pain that is a feature of fibromyalgia, other researchers now cite evidence that fibromyalgia may actually cause sleep disturbances.

Overview of Sleep Disturbances

Insomnia: Difficulty falling asleep or staying asleep. Symptoms include frequent awakening during the night, inability to go back to sleep, waking up too early in the morning, and feeling unrested upon awakening.

Sleep Apnea: Disturbance or disruption in breathing during sleep

Restless Legs Syndrome (RLS): A nervous system disorder that affects movements of the legs and interferes with sleep. RLS sufferers experience an irresistible urge to move their legs to relieve an uncomfortable ‘pins and needles,’ or ‘creepy crawly’ sensation, which is amplified in the evening and night and when lying in bed.

Fibromyalgia Effect on Brainwaves and Sleep Quality

Individuals who suffer from fibromyalgia report waking up feeling tired, unrefreshed, exhausted, and having no energy. This fatigue further gives rise to mood and cognitive disturbances, such as ‘fibro fog,’ or difficulty concentrating during the day.

Studies of the brainwave patterns of fibromyalgia patients show a deficit in the deep, restorative level of sleep during which the body repairs and replenishes itself, medically known as non-REM sleep (non-rapid-eye-movement sleep). Findings also indicate an alpha frequency rhythm called alpha-delta sleep anomaly, indicating stage 4 sleep deprivation, as well as a reduction in delta sleep, meaning a greater number of arousals.

Finally, research finds low levels of the hormone somatostatin in individuals with fibromyalgia, a hormone normally produced during deep sleep that enhances muscle and soft tissue health.

How to Improve Sleep Quality

Medications and/or strategies to control pain, as well as better sleep habits are the first steps to take in improving sleep quality for those suffering from insomnia or sleep apnea related to fibromyalgia.

Better sleep habits include:

•- limit time in bed to set hours, rather than spending excessive amounts of time in bed or napping during the day

•- wake up at a regular time (to improve circadian cycling and regular sleep onset)

•- exercise regularly, but not right before bedtime

•- avoid caffeine and alcohol in the evening

•- keep bedroom temperature cool, not warm

•- try relaxation techniques to promote restful sleep

If these strategies are insufficient, however, tricyclic antidepressants and selective serotonin reuptake inhibitors may be necessary, which appear to decrease fatigue, relieve spasms and muscle pain, and improve deep sleep in fibromyalgia sufferers.