Why Sleep is Crucial for Managing Fibromyalgia Symptoms
Fibromyalgia is a debilitating medical condition that causes overwhelming fatigue and widespread pain throughout the body. Fortunately, treatments are available to help fibromyalgia patients manage their symptoms and lead fuller, healthier lives.
Studies have found that improved sleep quality can help reduce the pain, drowsiness, mood disturbances, and cognitive difficulty associated with fibromyalgia. Measures that improve sleep quality can significantly reduce fibromyalgia symptoms and help people living with fibromyalgia find much-needed relief.
Fibromyalgia can cause a variety of symptoms including pain throughout the body; sleep disturbances; excessive daytime fatigue; stiffness in the muscles and joints; migraines; gastrointestinal issues, including irritable bowel syndrome (IBS); exceedingly painful menstrual periods; sensitivity to temperature changes; dizziness; problems with memory, cognitive function, and balance; and mood disorders, such as anxiety and depression.
Fibromyalgia is a chronic, incurable medical condition. Treatment involves alleviating symptoms and preventing flare-ups.
Fibromyalgia and Disordered Breathing During Sleep
Among fibromyalgia patients, rates of sleep apnea were found to be 61 percent among men and 32 percent among women, according to a 2013 study. A specific form of sleep apnea known as upper airway resistance syndrome is especially prevalent in women with fibromyalgia.
Sleep-disordered breathing is ten times more prevalent among people living with fibromyalgia than the general population.
Treating disordered breathing during sleep has been found to improve symptoms of fibromyalgia, including pain, fatigue, and cognitive dysfunction.
Disrupted Sleep and Fibromyalgia
Researchers at the University of Washington discovered that disrupted slow-wave sleep leads to reduced pain tolerance, as well as increased fatigue, discomfort, and skin inflammation. Slow-wave sleep is the deep sleep stage, and it tends to be disrupted in fibromyalgia patients. The results of this study indicate that disrupted sleep plays a critical role in the onset of fibromyalgia symptoms.
Numerous sleep studies have demonstrated that fibromyalgia patients suffer from disordered sleep. During deep sleep, fibromyalgia patients are either woken up or roused into a lighter sleep stage due to interrupted brain waves; as a result, these patients do not get enough uninterrupted, deep sleep. Subsequently, fibromyalgia sufferers wake up feeling unrefreshed and fatigued.
Fibromyalgia and Co-Occurring Sleep Disorders
Many fibromyalgia patients also suffer from other medical disorders that impair their ability to get a restful night of sleep. Treating these co-occurring sleep disorders helps improve the symptoms of fibromyalgia, as well. Treatment of co-occurring sleep disorders helps fibromyalgia patients achieve refreshing, restful sleep and improved quality of life.
- Restless Legs Syndrome
Restless legs syndrome (RLS) is ten times more common among fibromyalgia patients than the general population.
RLS sufferers experience a painful or uncomfortable sensation of numbness or tingling in the legs, along with an irresistible urge to move the legs. RLS symptoms tend to strike at night when the legs are at rest; for this reason, many RLS patients have trouble getting to sleep.
- Sleep Apnea
It is believed approximately half of fibromyalgia patients also have sleep apnea.
Sleep apnea is a serious medical condition that causes interrupted breathing during sleep. Common sleep apnea symptoms include snoring, waking up with a dry throat, and excessive daytime sleepiness.
In many cases, a spouse or another member of the household notices the signs of sleep apnea before the actual sufferer. For instance, a partner might notice her bedmate snoring heavily throughout the night and occasionally gasping for air during sleep.
Untreated sleep apnea can lead to a host of dangerous and debilitating issues including high blood pressure, increased risk of heart attack or stroke, irregular heart rate, higher risk of type two diabetes, complications during and after surgery, increased risk of nonalcoholic fatty liver disease and impaired liver function, and hypersomnia.
Treatment for sleep apnea typically involves using CPAP or EPAP devices to control snoring and promote unrestricted breathing during sleep.
Hypersomnia, characterized by extreme sleepiness during the day, can lead to chronic fatigue and irritability, trouble concentrating, falling asleep while driving or at work or school, depression, memory problems, and poor performance at work or school.
Hypersomnia can make it difficult or impossible to go about one’s normal daily activities and significantly hinders one’s quality of life.
Hypersomnia can be caused by other sleep disorders, including restless legs syndrome, narcolepsy, sleep apnea, and insomnia. Hypersomnia can also be caused by certain medications, medical conditions, or an abnormal sleep-wake cycle.
Hypersomnia is common in fibromyalgia patients, especially those who also have another sleep disorder such as sleep apnea or restless legs syndrome.
Treatment for Fibromyalgia and Associated Sleep Disorders
Nonprescription treatments for fibromyalgia and associated sleep disorders can help improve fibromyalgia patients’ quality of life with minimal negative side effects.
The following methods help fibromyalgia patients achieve improved sleep quality and relief of fibromyalgia symptoms:
Exercise can be beneficial for relieving the pain and sleeplessness caused by fibromyalgia.
- Proper Sleep Hygiene
Sleep hygiene refers to the practices that promote healthy sleep. Avoiding stimulants like caffeine and nicotine, exercise, a healthy diet, a relaxing sleep environment, and a calming bedtime routine are elements of good sleep hygiene.
- Herbal Supplements
Eating a nutritious diet and taking vitamin and mineral supplements can help promote healthy sleep.
- Mattress and Pillow Selection
Certain pillows and mattresses are specifically designed to help people with sleep issues fall asleep and stay asleep throughout the night. Anti-snoring pillows can help people with fibromyalgia and sleep apnea get a full night of refreshing sleep, which in turn can relieve the fatigue, pain, cognitive difficulties, and mood dysfunction associated with fibromyalgia.
Prescription Fibromyalgia Treatments
Certain prescription medications are sometimes prescribed both on- and off-label for the treatment of fibromyalgia symptoms. For some people with fibromyalgia, these medications help relieve the pain, mood changes, and sleep issues they experience.
Other fibromyalgia patients find these medications either don’t help at all or don’t help enough to make a meaningful difference. Furthermore, these medications tend to carry side effects that can be especially problematic for people with fibromyalgia.
- Cymbalta (Duloxetine)
Cymbalta is an antidepressant that has recently been approved by the FDA for fibromyalgia treatment. Cymbalta can help reduce pain in some people with fibromyalgia by stopping pain signals from reaching the brain.
However, not everyone treated with Cymbalta experiences decreased pain, or the reduction in pain might be minimal. Furthermore, Cymbalta can cause some side effects including nausea, diarrhea, constipation, headache, insomnia, and fatigue. Many of these side effects are already a problem for people with fibromyalgia.
- Savella (Milnacipran)
Savella is also an antidepressant approved by the FDA for fibromyalgia treatment.
Savella works similarly to Cymbalta. Like Cymbalta, Savella doesn’t always contribute to a meaningful reduction in pain. Savella can also cause side effects like a headache, nausea, stomach pain, constipation, and insomnia.
- Lyrica (Pregabalin)
Lyrica is an anti-seizure medication approved by the FDA for the treatment of fibromyalgia.
Lyrica can help reduce pain by blocking pain signals from the nerves. However, not everyone treated with Lyrica experiences reduced pain, and in some cases, Lyrica might not reduce pain enough.
Additionally, Lyrica can cause problematic side effects such as a headache, sleepiness, dizziness, trouble concentrating, nausea, vomiting, and dry mouth. Many of these side effects are already an issue for people living with fibromyalgia.
- Tricyclic Antidepressants
Although tricyclic antidepressants are not FDA-approved for fibromyalgia treatment, they are sometimes prescribed off-label to fibromyalgia patients. Amitriptyline, nortriptyline, and desipramine are examples of tricyclic antidepressants.
Tricyclic antidepressants can help promote sleep and relieve pain, fatigue, and depression. However, tricyclic antidepressants tend to cause more side effects than newer antidepressants. Tricyclic antidepressants can cause weight gain, orthostatic hypotension (a sudden drop in blood pressure upon standing, which can cause lightheadedness and fainting), sexual dysfunction, constipation, dry mouth, dizziness, blurred vision, and drowsiness.
Selective serotonin reuptake inhibitors (SSRIs) are a form of antidepressant medication sometimes prescribed off-label for fibromyalgia treatment. SSRI medications include Celexa (citalopram), Prozac (fluoxetine), Paxil (paroxetine), Lexapro (escitalopram), Luvox (fluvoxamine), and Zoloft (sertraline).
SSRIs can sometimes help alleviate the pain, depression, and sleeplessness that accompany fibromyalgia. However, SSRIs can also cause side effects such as dizziness, headaches, insomnia, blurred vision, drowsiness, dry mouth, nausea, upset stomach, diarrhea, lower sex drive, joint or muscle pain, rash, sexual dysfunction, and nervousness or irritability.
- Over-the-Counter Pain Relievers
Over-the-counter pain medication like Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen sodium) are sometimes recommended to ease the pain associated with fibromyalgia.
However, long-term use of over-the-counter pain medicines can lead to health problems. NSAIDs increase the risk of heart attack and stroke and can cause kidney problems, stomach ulcers, and stomach bleeding.
The debilitating pain and fatigue caused by fibromyalgia can wreak havoc on an individual’s quality of life. There is hope for fibromyalgia sufferers. Researchers have discovered that sleeping better at night can help ease the distressing symptoms caused by fibromyalgia. Taking steps to achieve healthy sleep can help fibromyalgia patients lead happier, more productive lives.