How are sleep disturbances related to fibromyalgia?

Dede Bonner
Health Education
Dr. Kim Dupree Jones, a fibromyalgia expert at the Oregon Health & Science University, says, “Sleep is so key in fibromyalgia. Treating sleep problems is so important.” 

It is, but patients and doctors sometimes get so focused on treating the fibromyalgia-induced sleeping problems that they miss other warning signs. Dr. Charles R. Cantor, a sleep medicine expert and the medical director of the Penn Sleep Centers of the University of Pennsylvania, explains, “It’s important that you and your doctor don’t just assume that your sleeping problems are related to your fibromyalgia. You may have symptoms that will lead your doctor to suspect something else is going on, like sleep apnea. People can fall through the cracks this way.”
Fibromyalgia and sleep disorders often go hand in hand. In fact, it is thought that up to 80% of people with fibromyalgia experience some type of disordered sleep. Why or how fibromyalgia effects sleep is not totally understood. Often, these sleep disorders leave people feeling tired and drained which may worsen other symptoms of fibromyalgia such as pain or depression. If some of these sleep disturbances can be corrected, often times many of the other symptoms of fibromyalgia are improved.
There are a number of steps you can take to help treat sleep disturbances, which may worsen your fibromyalgia symptoms and make the condition more difficult to manage.
  • Improve your sleep habits. Try to relax before bed by listening to soothing music or taking a bath. Stick to a regular sleep schedule -- that is, go to bed and get up at the same time every day. When you do turn in, don't watch TV or work on your computer while in bed. Your bedroom should be for sleeping.
  • Create a healthy sleep environment. Keep your bedroom dark, cool, and quiet while you rest.
  • Avoid daytime naps. Studies show that  siestas make it harder to get a good night's sleep.
  • Limit your caffeine and alcohol. Too much of either can disrupt your sleeping patterns.
  • Consider medication. In particular, small doses of antidepressants known as tricyclic medications appear to help promote healthier sleep in people with fibromyalgia. These medicines can help relax painful muscles, too.
Talk with your doctor about all strategies you can use to get better sleep.
Improved sleep for people with fibromyalgia can be obtained by implementing a healthy sleep regimen. This includes going to bed and getting up at the same time every day; making sure that the sleeping environment is conducive to sleep (i.e. quiet, free from distractions, a comfortable room temperature, a supportive bed), avoiding caffeine, sugar and alcohol before bed; doing some type of light exercise during the day, avoiding eating immediately before bedtime and practicing relaxation exercises as you fall to sleep. When necessary, there are new sleep medications that can be prescribed, some of which can be especially helpful if the person's sleep is disturbed by restless legs or periodic limb movement disorder. Scientific studies show that many people with fibromyalgia also have neurally mediated sleep apnea. It is a good idea to get a sleep lab study done to discover exactly what kind of sleep problem the person is dealing with. If the person does have sleep apnea, a continuous positive airway pressure (CPAP) machine or a special oral appliance created to move the jaw forward during sleep have been shown to be effective.
There’s some important news for millions of people -- most of them women -- who suffer from the syndrome fibromyalgia: a recent study suggests that sleep deprivation is associated with an increased risk of developing fibromyalgia.

The study was conducted at the Norwegian University of Science and Technology. The study included 12,350 women. At the outset of the study, all the women were free of physical impairment, musculoskeletal pain and fibromyalgia. A decade later, 327 of the women -- 2.6% of the study population -- had developed fibromyalgia. Researchers asked all the women in the study to report on their sleep habits and their sleep problems. They found that women who reported sleep problems were significantly more likely to have developed fibromyalgia than women without sleep problems. The researchers also found that the risk of fibromyalgia increases with a woman’s age, and with the severity of sleep problems.

It’s important to make clear that this study does not prove that sleep deficiencies cause fibromyalgia. What it does do -- for the first time -- is establish a strong connection between sleep problems and fibromyalgia by showing the increased risk of fibromyalgia that is associated with lack of sleep.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Sleep disorders are common with fibromyalgia, but they don't cause it. No one is sure exactly what causes fibromyalgia, but people who have the condition are probably genetically susceptible to developing it. What often happens is that an illness, an accident, or an emotional trauma triggers the onset of fibromyalgia. Sleep problems often accompany fibromyalgia, but they have not been shown to trigger the condition.
Jacob Teitelbaum
Integrative Medicine

Fibromyalgia can be triggered by dozens of different problems. These can include sleep apnea (consider this if you are overweight, snore, have high blood pressure, and fall asleep easily during the day) and restless leg syndrome (where your legs are jumping at night). Interestingly, treating even mild iron deficiency (despite normal blood tests) can be very effective at relieving restless leg syndrome.

The cause of fibromyalgia is unknown, but poor sleep definitely plays a role in the condition. If you have fibromyalgia, you may notice that your symptoms tend to flare up when you don't get a good night of sleep. Similarly, you may feel that you are getting plenty of sleep but still waking up tired. While it's impossible to say whether or not certain sleep disorders can actually cause fibromyalgia, they definitely have a tendency to aggravate the condition. Two of the most common are sleep apnea and restless leg syndrome. If you have either of these conditions, they may be disrupting your sleep without you even knowing. Talk to your doctor about possible treatment options.

Continue Learning about Fibromyalgia Causes

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.