The fibro catch-22: Most patients have trouble sleeping, but sleeping better can actually improve symptoms.(ISTOCKPHOTO)Almost 100% of fibromyalgia sufferers had problems with their sleep in a 2007 study, and the researchers concluded that for patients living with the syndrome "sleep quality was significantly predictive of pain, fatigue, and social functioning."
Patients who experience sleep problems may fall asleep but then wake feeling as tired as they were the night before.
"When you wake up in the morning and you're exhausted, it's not just the physical feeling," says Lynne Matallana, a fibromyalgia patient who cofounded the National Fibromyalgia Association (NFA) and wrote The Complete Idiot's Guide to Fibromyalgia. "It's also a scary feeling that your body is not functioning right, and you are not able to do the things you want to do."
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A possible explanation for aches and exhaustion
In 1975, pioneering researcher Harvey Moldofsky and his colleagues showed that healthy volunteers who had their sleep repeatedly disturbed developed fibromyalgia-like symptoms, including musculoskeletal aching in specific points around the body.
When asleep, healthy people pass through a cycle of progressively deeper stages of sleep, represented by fast alpha brain waves during the initial stages (indicating a half-awake state), and slow delta waves which are hallmarks of the later stages of deep sleep. But many fibromyalgia sufferers either don't reach deep sleep, or they don't stay there for long. Instead, alpha waves return, indicating to scientists that perhaps part of the brain is improperly active at that time. This phenomenon is known as alpha-delta sleep.
It is now known that crucial things happen to our bodies during deep sleep, including the release of most of the growth hormone that regenerates muscles, repairing all the tiny tears that we accumulate from daily activity.
Many researchers suggest that this lack of restorative sleep could be what's behind aching muscles, as well as the feeling of being totally worn out. (Growth hormone production declines with age, and this is accelerated in the majority of fibromyalgia cases.)
Next Page: Attacking sleep disorders can help [ pagebreak ]Attacking sleep disorders can help
Why fibromyalgia sufferers lose out on deep sleep is not yet known. But patients have low levels of neurotransmitters seratonin and dopamine, both associated with sleep and the ability to tolerate pain.
Other possible sources for skipping deep sleep: fibromyalgia patients involuntarily wake themselves up, because they often suffer from associated sleep disorders such as sleep apnea (momentary stoppages of breathing), restless legs syndrome (uncomfortable involuntary twitching), and bruxism (grinding of teeth).
Successfully treating these sleep conditions with medication can open up a whole new experience for longtime fibromyalgia sufferers: the experience of feeling awake and refreshed in the morning.
"I was very fortunate because there are now medications for restless legs syndrome, and that was one of the biggest problems keeping me awake," says Matallana. "If you don't have these things checked and treated, you will never get the quality of sleep you need."