Fibromyalgia, an example of a central pain syndrome, is a chronic health condition characterized by symptoms like widespread muscle pain, fatigue, memory problems and mood changes. Many people with fibromyalgia complain that sleep – or lack thereof – is one of the most frustrating challenges of living with fibromyalgia.
Sleep Problems with Fibromyalgia
Sleep problems are common among people with fibromyalgia. It is unclear whether lack of restorative sleep makes fibromyalgia symptoms worse or if pain from fibromyalgia makes it difficult to attain a good night’s sleep.
“We know that pain makes sleep quality worse,” says Daniel Clauw, MD, professor of anesthesiology, rheumatology and psychiatry at the University of Michigan in Ann Arbor. “But we also know that lack of sleep makes pain and other symptoms worse. They’re not independent of each other.”
Sleep issues in people with fibromyalgia often can send patients into a never-ending cycle of pain versus sleep.
“When I see patients with fibromyalgia who are also facing sleep issues, they’re often in a downward spiral,” Dr. Clauw says. “They’re in pain, which keeps them from getting good sleep, which leads to more pain. It just goes downhill from there.”
Unfortunately, a person who sleeps long hours can still wake up feeling unrefreshed. That’s because it’s not the amount of sleep that matters, but rather the kind of sleep. According to Dr. Clauw, many people with fibromyalgia do not achieve deep, slow wave sleep, also known as delta sleep. During slow wave sleep, the body fully relaxes, allowing tissue, muscles and energy to be restored. Without deep sleep, it is virtually impossible to wake up feeling refreshed.
How to Improve Sleep With Fibromyalgia
Before heading to your medicine cabinet, consider the habits you can adopt – or break – to improve your sleep quality.
“First, I recommend non-drug therapies and improvements to sleep hygiene,” Dr. Clauw says.
Sleep hygiene means doing things to make it easier for you to go to sleep and stay asleep. Dr. Clauw recommends:
- Only get in bed when you’re tired. If you haven’t fallen asleep after 15 minutes, go into another room and pursue a quiet activity until you’re sleepy.
- Use your bed for sleep. Avoid working, watching TV, eating, reading or checking your phone once you’re in bed.
- Don’t engage in stimulating activities right before bedtime. Avoid intense movies, books or projects that might make your mind restless before bedtime.
- Keep a schedule. Do your best to wake up and go to bed at the same time each day, even on weekends. Give your body about six weeks to get used to your new routine.
- While it is ok to have a small snack before bedtime, avoid having a heavy meal or a lot of liquid.
- Avoid caffeine at least four to six hours before bedtime. Caffeine can sneak into desserts, medications and tea, so be aware of what you’re putting in your body.
- Resist alcohol. While alcohol can help you sleep initially, it also contributes to frequent waking and increased trips to the bathroom.
“People drink caffeine in the morning and throughout the day to stay awake,” Dr. Clauw says. “But then they need something to help them relax, so they drink alcohol, which can be disruptive to sleep in the long run.”
While it may sound counterintuitive, especially when afternoon fatigue sets in, Dr. Clauw strongly cautions against napping during the day for people with fibromyalgia because it disrupts the body’s normal sleep patterns.
“The single most important thing is not to nap,” Dr. Clauw says. “Napping during the day virtually ensures a bad night’s sleep.”
If calming down after a busy day is your challenge, try relaxation techniques such as deep-breathing exercises or guided imagery. Take a warm lavender-scented bath to ease your mind and body. Make your room a calm, quiet place of rest and relaxation by adjusting the noise level, temperature and decor.
If improving your sleep hygiene isn’t effective after a few months, consider talking to your doctor about sleep medications, understanding that they may not offer the type of relief you need.
“There are medications that will definitely help you sleep,” Dr. Clauw says. “The issue is that they might help you sleep longer, but they won’t necessarily achieve that deep restorative sleep that you really need.”