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Chronic Fatigue Syndrome/ME
By Karen Lee Richards* •
April 22, 2011
The inability to get quality sleep and wake feeling refreshed is a major problem for most people who have fibromyalgia or ME/CFS.
More than 75% of people diagnosed with FM and approximately 60% of those with ME/CFS have difficulty falling asleep, staying asleep and/or awakening from sleep feeling rested and refreshed. And of course many millions of others struggle with these sleep disorders too.
Understanding the Problem
In order to understand why people with FM, ME/CFS, and other health issues have such a hard time getting quality sleep, it is first necessary to understand what happens during a normal sleep cycle.
Although you may think of sleep as a time of rest, your body is actually quite busy doing some of its most important work, like repairing cells, secreting certain hormones into the blood, and consolidating memories. It is also thought that the immune system turns on during deep sleep to combat illness.
When we sleep, our body cycles through five stages: 1, 2, 3, 4 and REM (rapid eye movement). This chart shows what occurs during each of the five stages of sleep:
||Light sleep - the time between being fully awake and entering sleep
- Easily awakened
- Eyes move slowly
- Muscle activity slows
||Onset of sleep
- Eye movements stop
- Brain waves become slower
- Body temperature drops
|3 & 4
||Deepest, most restorative sleep
- Brain waves become extremely slow
- Blood pressure drops
- Breathing slows
- Muscles relax
- Blood supply to muscles increases
- Tissue growth and repair occurs
- Energy is restored
- Hormones are released
||Brain is active and dreams occur
- Eyes dart back and forth
- Breathing becomes more rapid, irregular and shallow
- Limb muscles become temporarily paralyzed
- Heart rate increases
- Blood pressure rises
- Some ability to regulate body temperature is lost
- Energy is provided to brain and body
- Daytime performance is supported
- May contribute to memory consolidation
A complete sleep cycle takes about 90 to 110 minutes and is repeated four to six times per night, with the initial REM period occurring about 70 to 90 minutes after falling asleep. The first sleep cycles each night consist of relatively short REM periods and long periods of deep sleep.
As the night progresses, REM sleep periods increase in length while deep sleep decreases. By morning, most people spend nearly all of their sleep time in stages 1, 2, and REM.(1)
However, if you have FM and/or ME/CFS your body is probably not making it through the complete sleep cycle without interruption.
• A 2008 sleep study compared 26 ME/CFS patients (12 with coexisting FM) with 26 healthy controls. The researchers found that the ME/CFS patients had significantly reduced total sleep time, reduced sleep efficiency, and shorter bouts of sleep than healthy controls. They concluded that the sleep differences seen between the ME/CFS patients and healthy controls were primarily due to a decrease in the length of periods of uninterrupted sleep.(2)
• In 1975 Dr. Harvey Moldofsky first discovered that FM patients had an “internal arousal mechanism” that interrupted their stage 4 deep sleep(3), and multiple studies since then have confirmed his findings. This interruption of deep sleep by sudden bursts of awake-like brain activity is now called the alpha-EEG anomaly.
• A Danish review of research done on pain and sleep, with special reference to fibromyalgia, reported that most studies found the alpha-EEG anomaly to be very prevalent in FM patients.(4)
Finding a Solution
Often patients struggling with sleep issues are prescribed antidepressants or sleeping medications in an effort to help them sleep better. While these medications may help you fall asleep faster and sleep for longer periods of time, most of them do little to improve the important deeper sleep stages. Some even interfere with deep sleep. Plus, all medications carry the risk of side effects.
So finding a natural method of improving sleep quality offers a much better option. Which is why developing such an option became a mission recently for ProHealth founder & ME/CFS patient Rich Carson. As he tells it, "Sleep issues are huge when it comes to FM and ME/CFS, and I've had more than my fair share. After experimenting for months with different combinations of sleep-supporting herbs and nutrients, I came up with an all-in-one balanced formula I call FibroSleep™. It works like a charm for me."
FibroSleep Provides 4-Way Sleep Support
FibroSleep™ is a powerful blend of pure, natural ingredients that have been used for thousands of years to support deep, restorative sleep. It works in four important and synergistic ways:
1. Herbal Sleep Support - FibroSleep contains Sedapine™, a proprietary blend of herbs that have been used for thousands of years to provide effective support for sleep, relaxation, and general health. This Sedapine blend contains:
Ziziphus Spinosa – the most prescribed medicinal herb for sleep and relaxation support in China and throughout Asia.
Corydalus - historically employed in traditional Chinese and Native American medicine to support relaxation and stress reduction.
Valerian - the most researched sleep-supporting herb in the world. No herb has proven to be more effective in clinical trials for providing effective support for improved sleep. One review identified 12 studies showing that valerian by itself or in combination with hops was associated with improvements in sleep latency (the time it takes to transition from full wakefulness to sleep) and quality of sleep.(5)
Passion Flower - provides support for stress, anxiety, and sleep. It is also has calming and restorative properties.
2. Digestive Support - Calming and supporting the digestive tract is an important first step in attaining restful, restorative sleep. FibroSleep promotes deep sleep and digestive healing by addressing antioxidant and natural anti-inflammatory needs.
Lemon Balm - used to promote comfort, relaxation, and calm the digestive and nervous systems. It provides synergistic sleep support when combined with Valerian.
Ginger - a calming anti-inflammatory and digestive aid used to settle the stomach and promote peristalsis. It offers over 150 times the protein digesting power of papaya and contains at least 22 known anti-inflammatories and 12 antioxidants.
Peppermint - traditionally used as a relaxant, it calms the muscles of the stomach, helps reduce excessive gas production, improves the flow of bile used in fat digestion, and promotes proper elimination.
Hops - acts directly on the central nervous system to support the relaxation of smooth muscle tissue, improve central nervous system activity, and calm and soothe digestion.
3. Muscle and Nerve Support - Supporting muscle and nerve health is important for proper sleep. FibroSleep contains two highly bioavailable forms of magnesium to help balance nerve transmission and muscle fiber contraction, along with the calming amino acid, taurine.
ZMA™ - a great source of extremely bioavailable magnesium and zinc that supports sleep and healing by aiding in the transport of oxygen to nerve and muscle cells. Magnesium is the number one mineral deficiency in the United States, and zinc is the most important mineral for immune system function.
Magnesium Taurinate - a bioavailable yet gentle source of magnesium combined with the nervous-system-calming amino acid L-taurine.
4. Amino Acid Support - Amino acids are the building blocks of life and are critically important for nerve cell health as well as neurotransmitter and hormone production and balance.
GABA - the main calming amino acid in the central nervous system, this naturally produced substance helps to induce relaxation and sleep. It is also known for supporting healthy pituitary function as well as for its calming effect on over-stimulated neurons.
Melatonin - a natural hormone produced by the body that helps regulate other hormones and maintains the body's circadian rhythm. It supports the body's own production of the tranquilizing neurotransmitter serotonin, which plays a key role in healthy sleep patterns and mood. Recommended by more and more doctors as a safe and natural sleep enhancer, melatonin has become the most popular sleep-support compound in the natural food industry.
5-HTP - used by the body to make serotonin. Several small clinical trials have found it may provide significant support for fibromyalgia, sleep, mood, and migraines.
L-Theanine - a calming amino acid found in green tea that can increase levels of GABA (gamma-aminobutyric acid). Studies suggest it may reduce feelings of mental and physical stress and may produce feelings of relaxation. It is also thought to enhance immune function and boost levels of glutatathione. L-Theanine increases the brain's alpha wave activity, which is associated with deep relaxation.
Research Behind FibroSleep Ingredients
A number of interesting studies are available on both the individual ingredients in FibroSleep and various combinations of those ingredients as they relate to sleep quality. Here are just a few:
Valerian and Hops: A 1998 German study comparing the use of a hops-valerian combination with a benzodiazepine drug found them to be comparable in effectiveness for improving sleep. The one big difference was that those taking the drug benzodiazepine experienced withdrawal symptoms when they stopped, but those taking the hops-valerian combo did not. The investigators concluded that a hops-valerian combination was a “sensible alternative to benzodiazepine” for treating sleep problems.(6)
Passion Flower: A 2011 Australian study of 41 participants who were given passion flower tea and a placebo, separated by a one-week 'washout' period, found that their sleep quality improved significantly when they used the passion flower as opposed to the placebo.(7)
Melatonin, Magnesium and Zinc: Forty-three people with primary insomnia were given either a supplement consisting of melatonin, magnesium and zinc or a placebo one hour before bedtime for eight weeks in a 2011 Italian study. The group taking the supplement had significantly better scores on three different sleep-evaluation instruments, indicating that the treatment had a beneficial effect on the restorative value of sleep. The authors concluded that the nightly administration of melatonin, magnesium and zinc appeared to improve both the quality of sleep and the quality of life of the participants.(8)
GABA and 5-HTP: In a 2010 study, 18 patients with sleep disorders were given either a preparation containing GABA and 5-HTP (hydroxytryptophan) or a placebo. The researchers reported that the differences between the two groups were significant, concluding that the GABA/5-HTP combination reduced the time to fall asleep, decreased sleep latency, increased the duration of sleep, and improved the quality of sleep.(9)
ProHealth uses only the highest quality herbal extracts in their FibroSleep formula.
Recommended Dosage: 1-2 capsules one hour before bedtime.
Contraindications and Precautions:
Pregnacy and Lactation - Consult your obstetrician if you are pregnant or breast-feeding. Hops should not be used if you are pregnant.
Antidepressants - Consult your physician if you are taking prescription antidepressants.
Blood Thinners - Ginger stimulates circulation and should not be taken with blood thinning medications.
Salicylates - Some herbal components including peppermint and lemon balm contribute small amounts of salicylates, so may be of concern to sensitive individuals or those on the Guaifenesin Protocol.
The FibroSleep formula, personally developed by ProHealth founder and ME/CFS patient Rich Carson, is a powerful blend of pure, natural herbal ingredients that supports the deep, restorative sleep so needed by those with FM, ME/CFS, and the sleep disorders associated with other chronic health issues.
* Supplement research writer Karen Lee Richards is the Lead Expert specializing in Fibromyalgia and ME/CFS for HealthCentral's ChronicPainConnection. Karen is co-founder of the National Fibromyalgia Association (NFA) and was Executive Editor of Fibromyalgia AWARE magazine for four years.
1. “Brain Basics: Understanding Sleep.” National Institute of Neurological Disorders and Stroke. May 21, 2007.
2. Togo F, et al. “Sleep structure and sleepiness in chronic fatigue syndrome with or without coexisting fibromyalgia.” Arthritis Res Ther. 2008;10(3):R56. Epub 2008 May 13.
3. Moldofsky H, et al. “Musculoskeletal symptoms and non-REM sleep disturbance in patients with `fibrositis syndrome' and healthy controls.” Psychosom Med 1975;37:341–51.
Full text (download): www.psychosomaticmedicine.org/content/37/4/341.full.pdf+html
4. Drewes M. “Pain and sleep disturbances. Clinical, experimental, and methodological aspects with special reference to the fibromyalgia syndrome and rheumatoid arthritis.” Scandinavian Journal of Rheumatology 1999;28(2):126.
5. Salter S, Brownie S. “Treating primary insomnia - the efficacy of valerian and hops.” Aust Fam Physician. 2010 Jun;39(6):433-7.
6. Schmitz M, Jackel M. [“Comparative study for assessing quality of life of patients with exogenous sleep disorders (temporary sleep onset and sleep interruption disorders) treated with a hops-valerian preparation and a benzodiazepine drug”]. Wien Med Wochenschr. 1998;148(13):291-8.
7. Ngan A, Conduit R. “A Double-blind, Placebo-controlled Investigation of the Effects of Passiflora incarnata (Passionflower) Herbal Tea on Subjective Sleep Quality.” Phytother Res. 2011 Feb 3. doi: 10.1002/ptr.3400.
8. Rondanelli M, et al. “The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial.” J Am Geriatr Soc. 2011 Jan;59(1):82-90.
9. Shell W, et al. “A randomized, placebo-controlled trial of an amino acid preparation on timing and quality of sleep.” Am J Ther. 2010 Mar-Apr;17(2):133-9.
Note: This information has not been reviewed by the FDA. It is not meant to prevent, diagnose, treat or cure any condition, illness, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.
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| (1 existing comment)
|Posted by: uxordepp
Apr 27, 2011
Was this review helpful?
I have had insomnia for years. A sleep study last year once again found nothing notably amiss. My sleep efficiency was 85% though, which means to me that an 8-hour sleep period was delivering only about 7 hours. I was always sleepy and dragging, as I never seemed to get fully asleep. I awakened frequently. My mind never seemed to shut off. This went on for years.
And that was with two sleeping prescriptions!
Recently, I was put on Cytomel. Within a week, I was putting half a sleeping pill on my bedside table "just in case". Within a month, the sleeping pill was sitting in the cupboard.
The change has been remarkable. My sleep is not perfect. Neither do I feel optimized on my Cytomel. I think that I have found my answer.
If you can't sleep, get your thyroid checked!
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