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May 12, 2003
By Nicholas Rummell
Source: Missouri Arthritis Rehabilitation Research & Training Center (www.marrtc.org). Email contact: marrtc@health.missouri.edu. Reprinted with permission.
Judy Fry says her symptoms of sleep deprivation began long before she was diagnosed with severe fibromyalgia in 1983. A hyperactive child, Fry said she would awaken 10 to 30 times a night, then have trouble getting out of bed the next morning.
Today, Fry says her sleeplessness feels like what a "normal" person would experience after 48 hours of insomnia followed by working a full day's shift. "You don't have the energy to make new friends. You also learn not to make plans, because 99 percent of the time you can't keep them," said Fry, 53.
That means Fry picks her free-time activities carefully. While holding down a full time job, she makes sure she saves energy for her favorite hobby, tagging hummingbirds for the federal government. Fry has tried various medications, but none seem to work for very long.
About 90 percent of people with fibromyalgia syndrome (FMS) suffer from consistent sleep deprivation, according to the Fibromyalgia Network, a nonprofit organization headquartered in Tucson, Arizona.
Lack of sleep exacerbates the fatigue, stiff joints and depression common with fibromyalgia, a disease that affects 3.7 million people.
Sleep deprivation is not always immediately recognized, said Anne Winkler, M.D., medical director of the Smith-Glynn-Callaway Medical building's fibromyalgia program in Springfield, Missouri.
Some researchers say sleep deprivation lead to FMS, although the exact cause of FMS remains unknown. Winkler said she is not convinced sleep deprivation causes FMS but notes there is some clinical relationship.
For people with fibromyalgia, sleep difficulties can stem from the powerful medications necessary to counteract the severe pain that characterizes fibromyalgia.
DANGERS OF FATIGUE
Fatigue isn’t just a matter of being sleepy. Fatigue can be dangerous as well.
"People with FMS should be cautious about making long road trips, as well as operating heavy or dangerous equipment," said Winkler.
The four signs of fatigue include:
1. Lack of attention
2. Memory loss
3. Frustration with coworkers or friends
4. Poor concentration
In many cases, a person with fibromyalgia suffers from sleep disorders beyond insomnia. Adults with fibromyalgia may suffer from a lack of deep sleep as well as from constant waking throughout the night.
Deep, restorative sleep, also known as delta sleep, is the most crucial stage of sleep. It is during this stage that the body recovers energy and repairs muscle tissue.
Without delta sleep, a person with fibromyalgia might sleep eight hours yet wake feeling unrefreshed. This sleep problem can be difficult to detect - let alone treat.
In addition, a person with FMS may have traditional sleep disorders, as well such as apnea, or obstructed breathing, and periodic limb movement [including Restless Legs Syndrome].
"People should get checked out by a doctor," said Winkler. "Not only to properly diagnose fibromyalgia in order to obtain appropriate treatment, but because some of the associated problems, like sleep apnea, can be life-threatening."
© Missouri Arthritis Rehabilitation Research & Training Center. All rights reserved. Visit the MARRTC website: www.marrtc.org.
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