Fibromyalgia is a disorder associated with a number of uncomfortable symptoms, including mood disturbances, fatigue, and chronic pain. It affects about 2% of adults in the U.S.
Though the symptoms, diagnosis, and treatment for fibromyalgia are poorly understood, this disorder can have a major impact on sleep. We review the relationship between fibromyalgia and sleep, common sleep disorders that can occur alongside fibromyalgia, and how people with this condition can get better sleep.
How Fibromyalgia Affects Sleep
Fibromyalgia is best known for causing pain all over the body, but the majority of people with the condition also experience sleep problems.
Common sleep-related challenges for people with fibromyalgia include:
- A hard time falling asleep
- Frequent nighttime awakenings
- Feeling unrefreshed even after getting a full night’s sleep
- Stiffness after waking up in the morning
Much remains unknown about fibromyalgia, so even experts are not completely sure why the condition so frequently disturbs sleep. While widespread body aches may interfere with peaceful sleep, studies point to a deeper link between fibromyalgia and poor sleep.
A leading theory holds that fibromyalgia occurs because of irregularities in how a person processes pain. This may occur because of changes in the way the brain communicates and regulates the sensation of pain.
These same changes in the brain and central nervous system may explain the sleep problems associated with fibromyalgia. During overnight sleep studies, researchers have detected notable differences in the brain activity of people with fibromyalgia, including:
- Patterns of brain waves associated with wakefulness and insomnia
- Less time in deep sleep
- More frequent shifting between sleep stages
There is evidence that suggests that people with fibromyalgia may experience trouble sleeping before they start to have notable pain. Some people with fibromyalgia can have difficulty sleeping even if they have no discomfort or pain.
This sleep loss may actually contribute to the development of significant pain from fibromyalgia. As in many health conditions involving chronic pain, disrupted sleep can exacerbate pain and feed into a cycle in which poor sleep and pain worsen one another.
Fibromyalgia and Other Sleep Disorders
Fibromyalgia itself is closely associated with sleep problems, but people with fibromyalgia may also have other sleep disorders. These disorders, such as insomnia, sleep apnea, and restless legs syndrome, can compound feelings of fatigue in people with fibromyalgia.
Fibromyalgia and Insomnia
People with fibromyalgia are more likely to have insomnia, a sleep disorder defined by difficulty falling and staying asleep that leads to daytime tiredness.
Fibromyalgia can also cause symptoms that can interfere with sleep, such as pain, gastrointestinal issues, and mood disorders like depression.
Some people with fibromyalgia get plenty of hours of sleep but still feel exhausted when they wake up. This may be because some patterns of brain activity in people with fibromyalgia resemble those in people with insomnia. As a result, even people with fibromyalgia who do not actually have insomnia may experience daytime sleepiness.
Fibromyalgia and Sleep Apnea
Another sleep disorder that may occur in people with fibromyalgia is obstructive sleep apnea (OSA). OSA is a breathing disorder in which tissues in the airway leading to the lungs become constricted or blocked, causing breathing to be repeatedly interrupted during sleep.
OSA is very common, affecting up to 30% of U.S. adults, and it can cause daytime sleepiness and sluggishness. People with fibromyalgia can have OSA at the same time, which may partly explain their daily fatigue. Untreated OSA in people with fibromyalgia can reduce their sleep quality and worsen symptoms like pain.
As a result, it is important for doctors to assess whether people with fibromyalgia may have OSA. When diagnosed, OSA can often be effectively treated to improve sleep quality.
Fibromyalgia and Restless Legs Syndrome
When laying down to sleep, people with fibromyalgia may experience an urge to move their legs or have uncomfortable involuntary leg movements. These can be symptoms of periodic limb movement disorder (PLMD) or restless legs syndrome (RLS).
Periodic limb movement disorder involves repeated involuntary arm or leg movements. Restless legs syndrome is defined by a perceived need to move the limbs, most often the legs. Most people with RLS experience occasional involuntary limb movements.
These conditions can affect how easily someone can fall asleep as well as their ability to sleep continuously through the night. As with sleep apnea, these sleep disorders may contribute to daytime fatigue and other symptoms of fibromyalgia. For that reason, people with fibromyalgia and PLMD or RLS should receive tailored treatment to address these sleep-related movement disorders.
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How to Get Better Sleep with Fibromyalgia
Sleep disturbances are a prominent symptom of fibromyalgia, but there are ways to get better, deeper sleep while living with fibromyalgia.
Control Your Fibromyalgia Symptoms
While there’s no treatment that can cure fibromyalgia, there are therapies available to help reduce the intensity of your symptoms. You can work with your doctor to develop a personalized treatment plan to help control your fibromyalgia symptoms, including sleeping difficulties.
Health experts typically recommend an initial treatment approach for fibromyalgia that involves:
- Identifying and addressing factors that can aggravate fibromyalgia symptoms
- Working with a doctor or mental health counselor to change negative behaviors and thought patterns that may exacerbate symptoms and frustration about the condition
- Treating other underlying medical conditions, including sleep disorders
- Getting regular low-impact exercise
- Trying medications that may alleviate certain symptoms
Treating fibromyalgia often involves ups and downs. While symptoms may not ever go away completely, they can often be minimized to improve your daily quality of life.
Identify and Treat Sleep Disorders
If you have fibromyalgia, it’s possible that your sleep problems are being caused in part by a separate sleep disorder. For that reason, it’s important to talk to your doctor about any sleep issues that you have.
By reviewing your sleep patterns, your doctor can determine whether further testing is recommended to check for any underlying sleep disorders that may be aggravating your fibromyalgia symptoms. The doctor can also help prescribe treatment for any diagnosed sleep disorder.
Address Mental Health Issues
Up to 50% of people with fibromyalgia experience depression or anxiety. These mental health issues can have a significant impact on sleep and fibromyalgia pain.
That’s why it’s important for you and your health care team to incorporate caring for your mental health into your treatment plan. Let your doctor know if you:
- Frequently feel anxious
- Struggle to enjoy your favorite activities
- Often feel sad, irritable, or hopeless
If needed, your doctor can refer you to a mental health specialist and help you find effective ways to support your emotional well-being, which may help enhance your nightly sleep.
Get Regular Exercise
Health experts recommend incorporating regular exercise into your weekly routine for improving sleep and decreasing pain and other fibromyalgia symptoms.
Aerobic workouts are the most commonly recommended type of exercise for fibromyalgia. Choose the activities you enjoy the most, but try to start out with a low-impact option like biking, walking, or swimming. While there have been fewer studies about the impacts of resistance training, you may also get benefits from strength-based workouts.
Starting a new exercise routine can be a major hurdle to overcome, especially if you’re feeling tired and in pain. For that reason, it’s normal to start slow and tailor your workout to your personal interests and capabilities.
Reach out to your doctor or physical therapist if you need guidance about an exercise plan, and remember that even small changes in physical activity can add up to big improvements over time.
Practice Good Sleep Hygiene
Another step toward getting better sleep is to enhance your sleep hygiene. Sleep hygiene refers to a collection of daily habits that can influence how well you sleep at night.
Good sleep hygiene practices include:
- Keeping daytime naps short and not napping in the late afternoon or evening
- Avoiding caffeine and alcohol later in the day
- Not eating large meals close to bedtime
- Cutting down on screen time before bed
- Having a consistent sleep schedule
- Keeping your bedroom dark, quiet, and cool
Try Mindfulness Meditation
Mindfulness meditation involves focusing your attention on the present moment. While not a standard treatment for fibromyalgia, some evidence shows that regular mindfulness meditation may have benefits for sleep and other fibromyalgia symptoms.
You can ask your doctor or a mental health professional for resources to start mindfulness meditation. A number of guided meditations are also available for free online and through smartphone apps. Just be sure to modify your sitting position when meditating in order to make the process comfortable for you.
References
About The Author
Staff Writer, Product Testing Team
Alison is a health writer with ample experience reading and interpreting academic, peer-reviewed research. Based in San Diego, she is published in the journal PLOS Genetics and the Journal of Biological Chemistry and has been a copywriter for SmartBug media. With a master’s degree in biochemistry from the University of California, Davis, she has nearly a decade of academic research experience in life sciences. She enjoys helping people cut through the noise to understand the bigger picture about sleep and health. Alison likes to stay active with rock climbing, hiking, and walking her dog.
- POSITION: Stomach Sleeper
- TEMPERATURE: Neutral Sleeper
- CHRONOTYPE: Bear
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