Sleep Disorder in Fibromyalgia: Non-Restorative Sleep

Sleep Disorder in Fibromyalgia

Non-restorative sleep plays an important role in chronic conditions involving fatigue, pain, cognition and mood such as Fibromyalgia

One of the symptoms of Fibromyalgia is Sleep Disorder. It has been considered an integral feature of Fibromyalgia syndrome since patients with fibromyalgia recognize a connection with poor sleep and an increased pain, along with feeling un-refreshed, fatigue, and emotionally distressed.

Medical researchers have documented specific and distinctive abnormalities in Stage 4 deep sleep of Fibromyalgia patients.

During sleep, individuals with fibromyalgia are constantly interrupted by bursts of awake-like brain activity, limiting the amount of time they spend in deep sleep.

What is Non-Restorative Sleep?

Non-restorative sleep (NRS) does not have a uniform definition but the most common definition states that it is the subjective feeling that sleep has been insufficiently refreshing, often despite the appearance of physiologically normal sleep.

Sleep has been valued as a restorative time, making the person feel energized and refreshed. Therefore, non-restorative sleep is considered as poor quality sleep.

Non-restorative sleep is when People feel their sleep is restless, light, or of poor quality.

It was only in the 1970’s that researchers found a possibility of a connection between non-restorative sleep and fibromyalgia.

Can non-restorative sleep be treated?

It is difficult for non-restorative sleep to be treated. But there are ways of coping with it.

For example, cognitive behavioral therapy can help a person with fibromyalgia address non-restorative sleep.

A person suffering from fibromyalgia may also sleep medications but have to get it prescribed by a doctor.

These include physical therapy, therapeutic massage, myofascial release therapy, water therapy, light aerobics, acupressure, application of heat or cold, acupuncture, yoga, relaxation exercises, breathing techniques, aromatherapy, cognitive therapy, biofeedback, herbs, nutritional supplements, and osteopathic or chiropractic manipulation.

How is Non-restorative sleep and fibromyalgia linked?

Fibromyalgia is a condition where the patient suffers a widespread chronic pain all over. Even though there has been no known cause of fibromyalgia, sleep disorder has been one of the main symptoms of fibromyalgia.

This is where the link between fibromyalgia and NRS comes in. Sleep disorder in fibromyalgia is as same as the NRS.

In an NRS, a person feels that his or her sleep has been insufficiently refreshing or feel their sleep is restless, light or of poor quality. The same is reported by people with fibromyalgia.

According to the National Sleep Foundation, for people with fibromyalgia, the combination of pain and sleep disturbances is a double-edged sword, the pain makes sleep more difficult and so sleep deprivation exacerbates pain.

Fortunately, reduction in sleep disturbance is usually followed by improvement in pain symptoms. It highlights the importance of healthy sleep.

Sleep Problems in Fibromyalgia

Sleep problems with fibromyalgia include insomnia or difficulty falling asleep as well as frequent awakenings that you can remember the next day. Other sleep disorders include restless legs syndrome and sleep apnea.

Stages of sleep and its connection to fibromyalgia

There are five stages of sleep a person will experience in a normal sleep. It starts from light, deep to dreaming. Dreaming is the last stage and it occurs during REM or Rapid Eye Movement.

In a fibromyalgia patient, brain wave (EEG) studies have found that these patients lack the restorative levels of deep non-REM sleep.

It is during this stage (level 3 and 4) that a person’s body restores and refreshes itself.

It has been found that fibromyalgia patients are constantly awakened at this time which restricts their time in this crucial stage of restore.

EGG or brain wave studies have also found out that during the deep stages of sleep people with fibromyalgia have alpha waves which are signs of weakening.

They tend to experience at least twice as many awakening an hour compared to people without fibromyalgia.

How to get a goodnight’s sleep for fibromyalgia patients:

There are many strategies that one can follow to have a good night’s sleep for fibromyalgia patients.

More research needs to be done in order to definitively understand the relationship between NRS and fibromyalgia.

However, for now, general sleep hygiene guidelines, such as maintaining a daily routine and avoiding caffeine close to bedtime, should be followed in order to maximize restorative sleep.

According to the National Fibromyalgia and Chronic Pain Association (NFmCPA), better quality sleep can be obtained by implementing a healthy sleep routine.

Healthy sleep routine should include:

  1. creating the same time for going to bed as well as getting up in the morning every day.
  2. creating a conducive sleeping environment like free from any distractions, quiet, controlled room temperature, and a good bed.)
  3. avoiding coffee or caffeine, sugar, and alcohol before going to bed
  4. do light excise during the day.
  5. avoid eating immediately before your bedtime.
  6. practicing relaxation exercises as you fall to sleep.

If at all necessary, doctors also recommend sleep medications, some of which can be especially helpful if the patient’s sleep is disturbed by restless legs or periodic limb movement disorder.

The National Sleep Foundation also recommends some ways to cope with sleeping disorders. These include Prioritizing sleep, creating a quite environment, exercise, meditation, and massage.

There are many other strategies one can include in their healthy sleep routine.

  • It is recommended to sleep only as much as needed to feel refreshed and healthy the next day.
  • It is important to keep a sleep diary. This will help you keep a record of how you slept each night so that you can review it at a later stage.
  • Participate in relaxation therapies like gentle massage and breathing therapies which are beneficial in boosting restful and relaxing sleep.
  • Have a daily routine for light exercise.
  • Check your room for any sound which may disturb your sleep. Having a quiet room is a great advantage for a restful sleep.
  • Avoid taking daytime naps because this can interfere with your nighttime sleep.
  • Your room temperature should be cool. A warm room disturbs sleep.
  • Hunger may disturb sleep. Therefore, a light snack of carbohydrates may help sleep.



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