According to the National Institute of Neurological Disorders and Stroke, over 40 million Americans suffer from a chronic sleep disorder. I dare say a fair percentage of them are probably fibromyalgia patients.
In addition to pain and fatigue, sleep dysfunction is one of the primary symptoms of fibromyalgia. More than 75% of people diagnosed with FM have difficulty falling asleep, staying asleep and/or awakening from sleep feeling rested and refreshed.
In studies where healthy people were deprived of sleep, they developed many of the symptoms of fibromyalgia. That raises a chicken-or-egg-type of question – does fibromyalgia cause a sleep disorder or does a sleep disorder lead to fibromyalgia? No one really knows the answer, but we can be pretty sure that a lack of quality sleep is at least a significant contributing factor to many fibromyalgia symptoms.
The amount of sleep we need each night varies with the individual. Experts say that for most adults, between seven and eight hours is best, although some people can get by with as little as five hours while others need at least 10 hours of sleep to feel their best.
We commonly consider sleep as a time of rest. Actually, though, the body is quite busy repairing cells, secreting certain hormones into the blood, and consolidating memories. It is also thought that the immune system turns on during deep sleep to combat illness.
In order to understand the problems FM patients have in getting quality sleep, it is necessary to understand what happens during a normal sleep cycle. As we sleep, our body should cycle through five stages known as 1, 2, 3, 4 and REM (rapid eye movement).
Stage 1 – Light sleep - the time between being fully awake and entering sleep
- Easily awakened
- Eyes move slowly
- Muscle activity slows
Stage 2 – Onset of sleep
- Eye movements stop
- Brain waves become slower
- Body temperature drops
Stages 3 & 4 – Deepest, most restoratie sleep
- Brain waves become extremely slow
- Blood pressure drops
- Breathing slows
- Muscles relax
- Blood supply to muscles increases
- Tissue growth and repair occurs
- Energy is restored
- Hormones are released
REM – Brain is active and dreams occur
- Eyes dart back and forth
- Breathing becomes more rapid, irregular and shallow
- Limb muscles become temporarily paralyzed
- Heart rate increases
- Blood pressure rises
- Some ability to regulate body temperature is lost
- Energy is provided to brain and body
- Daytime performance is supported
- May contribute to memory consolidation
A complete sleep cycle takes about 90 to 110 minutes and is repeated four to six times each night. The initial REM period occurs approximately 70 to 90 minutes after falling asleep.
Early in the night, the sleep cycles consist of relatively short REM periods with long periods of deep sleep. As the night progresses, REM sleep periods increase in length while deep sleep decreases. By morning, the most sleep time is spent in stages 1, 2, and REM.
It's not unusual for FM patients to have one or more of three common sleep disorders:
- Alpha EEG Anomaly - the interruption of deep sleep by sudden bursts of awake-like brain activity. These periods of intense activity are measured as alpha waves on an EEG monitor. Alpha EEG Anomaly is prevalent in fibromyalgia patients, preventing them from getting the deep sleep that is essential to restore the body.
- Restless Legs Syndrome (RLS) - a disorder causing unpleasant crawling, prickling, or tingling sensations in the legs and feet resulting in an urge to move them for relief. Many RLS patients also have periodic limb movement disorder or PLMD, which causes repetitive jerking movements of the limbs, particularly the legs. These movements occur every 20 to 40 seconds and cause repeated awakening and severely fragmented sleep.
- Sleep Apnea - interrupted breathing during sleep usually caused by a mechanical problem in the windpipe. Sleep is disturbed with sleep apnea because when the windpipe closes, the person has to wake up enough to contract the muscles involved and begin breathing again.
The best way to determine whether you have any of these sleep disorders is to have a sleep study done.
For tips on ways to improve your sleep, read: The Fibromyalgia Sleep Dilemma – Part II: Finding Solutions
Brain Basics: Understanding Sleep. National Institute of Neurological Disorders and Stroke. May 21, 2007.
Published On: March 31, 2011