Fibromyalgia, commonly referred to as fibromyalgia syndrome, is a long-term condition marked by widespread muscle and joint pain and stiffness. There are around 4 million persons in the United States who suffer from fibromyalgia. There is no cure for this disease, but the symptoms can be controlled and even reversed with the right combination of medicine, therapy, and dietary modifications.
Fibromyalgia patients often have trouble sleeping as one of their many symptoms. As a result of the illness, some people’s symptoms are exacerbated by sleep problems, leading to a vicious cycle of pain and poor sleep. It is possible to alleviate fibromyalgia-related sleep disorders by practicing proper sleeping hygiene and developing healthy sleep habits.
How Does Fibromyalgia Affect Sleep?
Because of their lower pressure-pain threshold, those with fibromyalgia are more sensitive to pain than those who do not have this condition. “Abnormal pain perception processing” is the term for this. People with fibromyalgia and healthy adults appear to have similar brain activation, according to neuroimaging research.
Fibromyalgia is frequently accompanied by sleep problems and excessive tiredness during the day. This may be due to a lack of slow-wave sleep as a result of a person’s condition, according to some polysomnographic evidence.
Fibromyalgia and sleep are linked in a reciprocal manner. Sleep deprivation can increase the broad feelings of pain and tenderness that are brought on by fibromyalgia, just as uncomfortable symptoms can keep patients from obtaining adequate rest. A person’s pain tolerance may be lowered as a result of a lack of sleep. As a result, fibromyalgia symptoms may develop in otherwise healthy people who do not get enough sleep.
The vast majority of fibromyalgia sufferers are in their forties and fifties. Fibromyalgia affects an estimated 80% to 90% of women. In addition to rheumatoid arthritis, spinal arthritis, and lupus, the symptoms of fibromyalgia might be worsened if a person has any of these disorders. Insomnia and restless legs syndrome have also been connected to fibromyalgia.
Fibromyalgia and Insomnia
Chronic trouble falling or staying asleep, despite having the means and chance to get enough sleep each night, is the hallmark of insomnia, a sleep disorder. Even during the day, insomniacs are affected by symptoms including weariness, mood swings, and a lack of drive and enthusiasm.
It is common for patients with fibromyalgia to suffer from insomnia. Fibromyalgia is often diagnosed by looking at symptoms like insomnia, exhaustion, and poor quality of sleep. Insomnia can exacerbate fibromyalgia symptoms by lowering your pain threshold.
Cognitive-behavioral therapy for insomnia (CBT-I) is an organized and evidence-based treatment program that identifies the ideas, feelings, and actions that may be contributing to the patient’s symptoms. People with fibromyalgia often have atrophy of the gray matter in their central nervous system, which CBT-I has been shown to reduce or reverse in a recent study.
Other studies have looked at the effects of sleep medicine on fibromyalgia pain. If you suffer from fibromyalgia and are prescribed the insomnia medicine suvorexant, you will sleep longer and experience less discomfort the following day.
Talk to your doctor about CBT-I, medication, or other therapy options that may help alleviate the symptoms of both insomnia and fibromyalgia.
Fibromyalgia and Restless Legs Syndrome
Willis-Ekbom disease, commonly known as restless legs syndrome, is a condition that causes a strong impulse to move or adjust the legs, which is sometimes accompanied by unpleasant sensations.
The worst symptoms of RLS are frequently felt while lying down or sitting in the evenings or at night. Walking or stretching can briefly reduce the discomfort, but the symptoms generally return as soon as the person’s body is put to rest once more.
Fibromyalgia and RLS appear to share many symptoms. Both fibromyalgia and RLS have sensory abnormalities in common, therefore some individuals may be mistaken as having fibromyalgia when they actually have RLS. In certain cases, treating the underlying causes of RLS might help alleviate the symptoms.
Diagnoses & Treatments
obstructive sleep apnea is one of the most common issues that a sleep specialist looks for while evaluating a fibromyalgia patient’s sleep issues (OSA). Robert S. Rosenberg, DO, the medical director of the Sleep Disorders Center in Prescott Valley, Arizona, and the author of The Doctor’s Guide to Sleep Solutions for Stress & Anxiety, says OSA is a prevalent sleep issue among fibromyalgia sufferers. Snoring can be a simple indicator, but sleep specialists will do a sleep study and look at other symptoms to determine if there is a problem.
Dr. Rosenberg says she sees an increase in the prevalence of upper airway resistance syndrome in women with fibromyalgia, which is another common OSA variant. While their oxygen levels remain unchanged, he asserts that they actually awaken.
Dr. Dasgupta does not check all fibromyalgia patients for OSA, but he does keep it in mind. OSA can be seen in patients who obtain seven to eight hours of sleep but don’t feel rested, according to the doctor.
Doctors routinely use a CPAP mask to treat sleep apnea. Patients may be wary of receiving a CPAP because they’ve witnessed family members struggle with it, but Dr. Dasgupta is here to reassure them. Although a mask is necessary when using a CPAP, “Darth Vader” isn’t the only one that can be found on the market. Positional therapy, a dental appliance, or even surgery to remove tonsils can also help some patients with OSA avoid CPAP use. Even while “most of the previous [surgical techniques] are not successful, there is a place for some individuals,” Dr. Rosenberg notes.
According to Dr. Dasgupta, sleep specialists often recommend weight loss and exercise for people with OSA. Obesity, heart disease, and diabetes are common co-morbid conditions in patients with OSA. In addition, he says, doctors must determine whether the patient is taking any additional medications that could exacerbate breathing problems or if he or she has OSA that has gone undiagnosed.
Dr. Rosenberg believes that treating OSA in people with fibromyalgia is beneficial. “Fatigue and pain are greatly reduced. There are long stretches of REM sleep and increased production of growth hormone,” according to the study.
According to Dr. Dasgupta, restless leg syndrome (RLS) is common among fibromyalgia patients, especially iron-deficient women and women of childbearing age. RLS is found in almost half of fibromyalgia patients, according to the doctor. Twitching in the legs is one of the most common symptoms, and it’s worse at night and when you’re sleeping. As a sleep disorder, restless leg syndrome (RLS) is not recognized by the American Academy of Sleep Medicine. To ignore the symptoms, Dr. Rosenberg explains, “it’s not uncommon for clinicians to suggest it’s fibromyalgia pain”.
An iron shortage, kidney difficulties, or untreated diabetes may be the fundamental cause of RLS, which can be treated with medicine. Treating RLS also helps alleviate the symptoms of fibromyalgia, as it does with OSA.
Fibromyalgia patients sometimes suffer from insomnia as well. As a CBT-trained insomnia therapist, Ms. Kormeili is able to cure insomnia with the aid of CBT. When it comes to sleep issues, “Cognitive behavioral therapy focuses on changes in ideas and actions,” she explains. Fibromyalgia patients who use CBT for sleeplessness can improve their pain control.
Laughter yoga and even gratitude exercises are two of the many techniques she employs in her practice. Using CBT also helps clients gradually reduce their use of sleeping drugs, according to her findings..
Patients with fibromyalgia can benefit from the expertise of both sleep specialists and rheumatologists in addressing common sleep issues, such as:
- tracking your sleep patterns and addressing any concerns that arise;
- Taking regular exercise;
- Maintaining a regular and consistent sleep pattern and just using the bed to sleep are all examples of good sleep hygiene.
- The practice of meditating and relaxing oneself
- Night-time usage of artificial light and electronic gadgets should be reduced or completely eliminated.
- Sleeping pills like melatonin, and focusing on the good things in life.
“We see the world through dark, gloomy glasses and tend to overlook things that are going right,” Ms. Kormeili explains when we are depressed, nervous, or sleep-deprived and in chronic pain. Those with fibromyalgia are more likely to benefit from practices like gratitude awareness.
What About Sleeping Pills?
Both rheumatology and sleep medicine experts tend to avoid using sleeping tablets as a kind of treatment for sleep disorders. “With many sleeping drugs, brain waves on electroencephalography begin to reveal odd signs. Dr. Yeam argues that long-term usage of sleep medicines has led to an increase in accidents and early dementia.
Patients with fibromyalgia are also more likely than the general populace to be exposed to doctors and medications, which might lead to a greater emphasis on the use of drugs and gadgets to enhance sleep. According to him, “all of these can lead to habits and preconceived views that may not be beneficial to a healthy sleep schedule”.
After prolonged usage, all sleeping medications become addictive and cause relapses of insomnia. Medical director and founder of the Columbia University Lupus Center in New York City, as well as an associate professor of medicine at Columbia University Medical Center’s Division of Rheumatology, Dr. Anca D. Askanase advises against long-term usage of these drugs.
In addition to the aforementioned treatments, it’s crucial to offer patients a better grasp of what a good night’s sleep is, Dr. Yeam says. “Perfect sleep is one of the misconceptions I’d like to dispel,” he says. There is no “perfect” sleep, as defined by most individuals. Sleep is a dynamic state that progresses through a number of stages. The brain does not go into hibernation or sleep. There is a lot of cerebral activity going on.”
As a result, there is a lot of nighttime cycling between sleep and brief arousal. “Sleep isn’t flawless,” he says. Awakening, we toss and turn. “It’s found in regular, healthy sleep,” he explains.
How Can You Help?
It’s understandable that many rheumatologists are already overworked and can’t dedicate much time to helping patients with fibromyalgia or any other rheumatological ailment sleep better. According to sleep specialists, there are a few things they may do to get the conversation started. To begin, have a team of medical professionals reviews your fibromyalgia patients to ensure they are receiving the best possible therapy. Dr. Askanase believes that in addition to their main care physician and rheumatologist, individuals with fibromyalgia need to see a psychologist, a physical therapist, a psychiatrist, and a sleep specialist for their treatment. Understanding the importance of a team approach in fibromyalgia is crucial.”
The STOP-Bang and Berlin online questionnaires can also be helpful in OSA evaluation. Having people fill it out while they’re in the waiting room can assist diagnose OSA. It takes approximately four minutes to complete.” “Even your medical assistant can do it,” Dr. Rosenberg remarked. Sleep specialists may be referred to those who complete surveys like this one.
When evaluating a patient, you can also ask a few straightforward questions about the patient’s sleep habits. It’s a simple question that Dr. Dasgupta advises. Dr. Rosenberg recommends that you also inquire about the patient’s sleeping habits and the number of times they wake up at night.
Finally, seek advice from a sleep professional as soon as possible. It’s surprising to Dr. Rosenberg how many rheumatologists and neurologists he sees who don’t ask about sleep disorders at all, and who tend to overlook or mischaracterize RLS symptoms in their patients.
Patients with fibromyalgia can improve their symptoms and quality of life by taking a more holistic approach to sleep quality.
Sleep Tips for People With Fibromyalgia
Some fibro drugs target the pain that keeps you awake at night, while others may improve the quality of your night’s sleep. To help you sleep better and longer, an extended-release formulation of the medication may be more effective at reducing discomfort.
Some people, however, do not benefit from medicine in the same way, or at all.
Fibromyalgia treatment requires regular exercise, but the timing is critical. The quality of your sleep at night can be improved by working out throughout the day. You may be unable to fall asleep if you engage in strenuous activities within three hours of going to bed.
The water’s ability to buffer your body’s impact makes working out in a pool seem less difficult.
Slow, deliberate movements are combined with deep breathing in the ancient mind-body practice known as tai chi. All of this can lead to greater sleep, less discomfort, and less anxiety.
Taking a bath and listening to music before bedtime can help you sleep better. Listening to music at night can help alleviate symptoms for sufferers of fibromyalgia, researchers found in a four-week trial. Sonic Aid’s “Music to Promote Sleep” was selected because of its unique beats.
Cognitive Behavioral Therapy
A brain is a tremendous tool for health and well-being. ” Cognitive behavioral therapy (CBT) is an approach that teaches you how to change your thoughts for the better.
It’s possible that fibromyalgia-related sleeplessness can be helped with cognitive-behavioral therapy (CBT). If you’re stuck in a downward spiral of negative thoughts, this can be extremely helpful: As a result of their suffering, many people worry that they won’t be able to sleep, which in turn worsens the pain and makes it more difficult to fall asleep.
Healthy Sleep Habits
You’ll learn about healthy sleep practices when you visit a sleep specialist for insomnia. The quality of your sleep will improve if you follow these simple actions to relieve pain and weariness.
Make sleep a priority and stick to a regular bedtime and wake time. Every day, regardless of the weekend, go to bed and rise at the same hour.
Create a peaceful atmosphere in your bedroom. Chronic pain can be exacerbated by loud noise, such as a blaring television. Make sure the room is well-ventilated, dark, and quiet. It’s time to invest in a good mattress and bedding.
Avoid taking naps during the day because they can disrupt your sleep at night. It’s okay to sleep in for up to 60 minutes, but as soon as you’re awake, get to moving.
Avoid caffeine-containing beverages like coffee and tea, as well as alcoholic beverages, after dinner. As a precaution, you may want to refrain from drinking beverages for several hours before bedtime.
Stay away from nighttime activities that keep your mind racing, such as working till the wee hours or binge-watching a gruesome thriller. At least an hour before the lights go out, turn off all electronic devices. You can then relax by taking a hot bath or practicing deep breathing.