Reprinted with the kind permission of Celeste Cooper
Snooze, you lose –
Loss of slow wave sleep progression
Disordered sleep is prevalent in both fibromyalgia and chronic fatigue syndrome/myalgic encephalitis. Loss of sleep and ineffective sleep patterns affect our mental, physical, emotional, and spiritual health and weaken our immune response.
Sometimes, many times, despite doing everything right, a road block occurs and we literally lose our map to life. I believe poor sleep quality and quantity should be addressed, and all patients with FM and CFS deserve to have a sleep study to evaluate and properly address their problems.
Disorder in bed court!
Sleep disorders are characterized by different circumstances. Sleep apnea, for instance, is an obstructive sleep disorder and can co-exist with FM and CFS/ME. When this happens, a person is deprived of the oxygen needed for cellular metabolism and energy. Disordered sleep, meaning that the normal cycles of sleep are not present, not maintaining sleep, and delayed sleep onset have been consistently reported by fibromyalgia (FM) and chronic fatigue syndrome (CFS/ME) patients.
Many of us seldom, if ever, enter deep stages of sleep, so I am including a link
regarding slow wave sleep (SWS), which may in the future be defined as one stage)
We also have other co-existing conditions that cluster with both FM and ME/CFS: teeth grinding (bruxism), periodic limb movement (PLM), TMJ, sleep starts, and delayed sleep phase (inability to fall or maintain sleep). These can and do play a role in sleep quality, and I am advocating that an assessment for myofascial trigger points, RLS and PLM be included in the proposed diagnostic criteria for FM and a better explanation for “jaw pain.”
Sleep deprivation can impede healing, foster agitation, and when severe, cause psychosis. This might explain why so many of us have difficulty fighting off viruses and recovering from injury, which is normally repaired during sleep.
To medicate or not to medicate
According to the Wikipedia link, it seems alcohol (I am assuming not too much, though they don’t state such), THC, and SSRIs, and possibly Xyrem can promote slow wave sleep (SWS), and benzodiazepines, such as Klonopin, can inhibit SWS.
I bring up Klonopin specifically because it is often prescribed to help with the periodic limb movement (PLM) seen in the FM and CFS/ME patient. This leads me to conclude that the treatment for PLM may also be an aggravating factor for lack of SWS. Other treatment suggestions for PLM include sleeping pills, anti-seizure medications and narcotic pain killers.
Our best bet is to find a good sleep specialist that understands FM and ME/CFS. You and he/she can work together.
Promoting your circadian rhythm
Our circadian rhythm is orchestrated by two markers, melatonin concentration and core body temperature.
A Helpful Acronym for Sleep Hygiene ©
- Schedule bedtime and stick to it
- Limit physical activity before bedtime
- Use comfort measures
- Meditate (count those lambs)
- Eliminate stress and food (including caffeine 2-3 hours prior to bedtime)
- Remember nothing — clear your mind (journal your to-do list so you can let go)
Celeste Cooper, RN, is a frequent contributor to ProHealth. She is an advocate, writer and published author, and a person living with chronic pain. Celeste is lead author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and Broken Body, Wounded Spirit, and Balancing the See Saw of Chronic Pain (a four book series). She spends her time enjoying her family and the rewards she receives from interacting with nature through her writing and photography. You can learn more about Celeste’s writing, advocacy work, helpful tips, and social network connections at CelesteCooper.com