Fibromyalgia and Sleep Disorders
Chronic fatigue is one of the key symptoms of fibromyalgia, along with chronic pain. Both issues can be linked to sleep issues.
Symptoms of sleep issues can include
- Trouble falling asleep easily
- Waking throughout the night
- Restless sleep (aka tossing and turning)
- Waking too early
- Waking feeling unrefreshed (as if you’ve not slept)
I’ve experienced all of these. Given how common sleep issues are within fibromyalgia and other chronic illnesses, I’m guessing you have as well.
These symptoms may be a sign of a bigger problem and/or a problem that may potentially be causing some, or all, of your other symptoms.
I’m still amazed that sleep testing isn’t an integral part in diagnosing fibromyalgia. Before you begin simply treating symptoms, these sleep issues should be ruled out as potential causes for your symptoms.
Types of Sleep Issues
There are close to 100 different types of sleep issues that can potentially cause these symptoms.
The most common sleep disorders among those with fibromyalgia are:
Insomnia
Insomnia is a catch all we use to describe issues with falling and/or staying asleep. Insomnia can be both a symptom of another disorder, a disorder in itself, or a side effect of a medication. When it comes to fibromyalgia it’s really difficult to know which of these you are dealing with.
Chronic pain can cause or increase insomnia as it can be difficult to fall or stay asleep when your body hurts. If you are taking medication for the chronic pain, that medication can also disrupt your sleep cycle and cause insomnia.
About 1/3 of adults suffer from some type of insomnia.
Treatment for insomnia varies and is often the result of trial and error on the part of person living with it. Treatment for insomnia may include increased exercise, meditation, change in diet, supplements to increase relaxation, and medications.
After years of dealing with insomnia I found a combination of diet change (reducing acidic foods), reducing stress, and taking CBD oil the best treatment for me.
Sleep Apnea
Sleep apnea is when you stop breathing during sleep. You may only stop for a few seconds, or you may stop for much longer.
There are three main types of sleep apnea.
- Obstructive sleep apnea is the most common type of sleep apnea. Obstructive sleep apnea is caused when part of the airway is blocked during sleep.
- Central sleep apnea is caused by the brain not sending the correct signals telling your body to breath. Your breathing will be interrupted many times through the night when your brain fails to send these signals.
- Mixed sleep apnea is a combination of both obstructive sleep apnea and central sleep apnea.
Sleep apnea is rather common with some 20% of adults suffering from some form of sleep apnea.
The most common treatment for sleep apnea is use of a CPAP machine.
Restless Leg Syndrome
Restless leg syndrome is the uncontrollable urge to move your legs and arms when resting or sleeping. This (near) constant movement can result in unrefreshed sleep for both you and your bed partner.
About 1 in 10 people suffer from restless leg syndrome.
Treatment for restless leg syndrome includes a reduction in caffeine, increase in exercise and water, and sometimes medication.
Additionally, many people with fibromyalgia also suffer from bruxism (teeth grinding), which may be related to TMJ disorder, or night terrors (often caused by medications). I’ve experienced both of these for the reasons mentioned.
Why is sleep testing important for fibromyalgia
Unfortunately, despite all the sleep issues that I endured, my doctor didn’t order sleep testing until I pushed back and requested it.
I really don’t understand how sleep testing isn’t part of the diagnostic process when it comes to fibromyalgia. Why do doctors not order sleep testing while they are ordering all those blood tests and scans?
I don’t have the answer to that.
But, when 50% of patients with fibromyalgia are diagnosed with obstructive sleep apnea, there’s an issue. An issue that is obviously being overlooked for many patients who aren’t receiving sleep testing.
But, I would say that if you struggle with sleep-related symptoms you should talk to your doctor about sleep testing. It may be helpful to take these online sleep tests from Aeroflow and print the results to take with you to help assist in the discussion.
What does sleep testing involve?
It used to be that sleep testing required an overnight stay at a sleep clinic. When I had my sleep study done years ago, I arrived at about 8pm to be hooked up to a bunch of monitors.
I was able to take my normal sleep aids in hopes of sleeping as well as possible. You would think that being in an unfamiliar location with wires all over your head would make it even more difficult to sleep, but I didn’t really notice a difference.
The technicians hook you up then leave the room but watch you through a window while you sleep. The various machines they hook up to you monitor your breathing, heart rate, and movement while you sleep.
Then about 6am they woke me up, told me I could take a shower and get dressed and head home.
Thankfully, I didn’t have sleep apnea, but I did occasionally stop breathing during sleep. Everyone does to some degree. It’s only after a certain point that treatment becomes necessary. A low-dose antidepressant was suggested to me for treatment.
These days sleep testing can be done from the comfort of your own bed. However, there is debate over whether this type of testing is as complete or accurate as going in for a sleep study.
Sleep testing is generally covered by your insurance. Often, your insurance may require that you undergo the in-home sleep study first. Then, if those results are inconclusive for any reason you may be brought in for a full sleep study.
If you do need a CPAP or other sleep-assist products or medications your insurance will usually cover and arrange those for you. These products can be ordered online from Aeroflow and delivered right to your door, saving you the hassle of visiting a store. Auto-orders make it even simpler making sure that you have updated supplies as needed.
Have you undergone sleep testing? Were you diagnosed with sleep apnea or another sleep disorder? Share your thoughts in the comments below.
Related:
- Symptoms & signs of fibromyalgia
- The fibromyalgia treatments that have helped me most
- Are sleep issues at the root of many fibromyalgia symptoms?
- Wearables for tracking sleep & improving pain
References:
Köseoğlu, H. İ., İnanır, A., Kanbay, A., Okan, S., Demir, O., Çeçen, O., & İnanır, S. (2017). Is There a Link Between Obstructive Sleep Apnea Syndrome and Fibromyalgia Syndrome?. Turkish thoracic journal, 18(2), 40.
Lisamarei says
I was diagnosed based on a sleep study and first given a cpap but then switched to a apap and it is working much better. I don;t like wearing the device but I do feel better when I get that REM sleep. I also appreciate waking up feeling rested instead of light headed or like I have a hangover!
Julie says
So glad it’s helping. I don’t really know the difference between CPAP and Apap, care to enlighten?
Sharon says
Greetings! I’m glad to have ‘stumbled’ (heh) upon your site. Very informative. My friend thinks I should skip going to the rheumatologist and just get tested for Lyme. She says if I gave Lyme that will explain my fibromyalgia symptoms. Your thoughts? Also, is there a good forum for fibromyalgia that you can recommend? Thank you, keep up the great work.
Julie says
I’d definitely get tested for Lyme. The caveat is that the Lyme tests are not extremely accurate so there’s a lot of false positives. If your GP hasn’t already done testing to rule out all other potential causes (including a sleep study) I’d go that route first.
I don’t necessarily feel that a Rheumatologist is needed. There’s some debate over whether they are really the best to treat fibro as more and more studies are showing that it’s a nervous system disorder and not a musculoskelatal disorder. It’s frustrating because it means a lot more work on our part to dig into it.
I recently switched to having my GP handle my fibro care. While my rheumatologist has an NP on staff that handles the fibro patients I’ve found him lacking the last couple of years as far as staying up to date on new info and treatment options. So, my appointments have become frustrating and basically just an expensive stop-in to get medication refills (that my GP can refill for me).
I guess I’m saying all that to say that whoever you have treat your fibro a) you’ll still need to do a lot of research yourself and b) make sure that they are aware of current treatment options (or willing to explore if you have to help them stay aware). No doctor can keep up with every possibility for every illness they treat, so a little leeway is necessary.
Amy says
I’ve had Fibromyalgia for 10 years. Fatigue has recently become unbearable. My new doctor ordered a sleep study.apparently , my oxygen levels drop while I sleep. I was fitted with a custom oral mouthpiece by a dentist. Medicare did not pay! Restorative sleep has improved greatly. Depression and fatigue issues have improved greatly. Any suggestions on how I can get Medicare or supplement to reimburse me for the treatment and mouthpiece?
Julie says
I wish I had answers there. Have you tried contacting a case worker to find out if there may be alternative treatments they would pay for? Often, with insurance they want you to go up a ladder of treatments. As the mouthpiece came from your dentist they probably see that as a dental treatment instead of a medical treatment. Perhaps talk to your new doctor and see if they might be able to help… although probably not since it’s after the fact (had they been involved on the front end- prescribed the dental mouthpiece – they might have been able to help more.