Do you struggle to sleep? If so, you’re not alone. More than 75% (1) of people living with Chronic Fatigue Syndrome and fibromyalgia have trouble falling asleep and staying asleep. Trouble sleeping is especially harmful if you are living with a chronic illness, because it can make all of your symptoms worse the next day.
Why is getting a good night’s sleep so hard, and how can we improve our sleep without using harmful medications?
When I was younger my family used to joke that I could sleep through a fire alarm. Yet after I was diagnosed with chronic fatigue syndrome, just the slightest noise would wake me.
I started going to a sleep specialist and tried medication after medication. Some of them worked and some of them didn’t, but none of the pills had a lasting effect. My pharmacist looked at me with worry every time she handed over a new prescription, warning me that these pills were not meant for long term use. But at the time, I had no other options.
I didn’t understand why I couldn’t fall asleep. It seemed like another mystery of CFS that couldn’t be solved. But as I started to heal, I learned a lot about how my body was functioning with illness, and the trouble sleeping began to make sense.
First, I began learning about the Central Nervous System (CNS) and it’s two parts: The sympathetic nervous system (SNS or 'fight or flight'), and the parasympathetic nervous system (PNS or 'rest and digest'). Both of these nervous systems are vital to living safe and healthy lives. Yet at some point over the course of my CFS, my ‘fight or flight’ system had taken over(2). The sympathetic nervous system becomes active during times of real or perceived stress. Living with CFS and fibromyalgia is pretty stressful, so it makes sense that many people with these illnesses will have an overactive stress response. In times of acute stress, this is essential for survival, but if the stress becomes chronic, this response can actually do more harm than good.
Some symptoms of an overactive SNS at bedtime are:
An overactive mind, thinking about what you need to do the next day, worrying, feeling like your mind won’t ‘shut off’ before bed.
A feeling of tension in your body, like you just can’t relax even though you are very tired.
If you think that this may be at the root of your sleep problem, know that you are not alone, and that there are natural tools you can use to help you get a better night’s sleep.
Karen Lee Richards wrote an article for Prohealth last year about finding the right natural supplements to help you get a good night’s sleep. I think supplements are great, but I like to take the double armour approach. Using two methods at once to increase effectiveness.
The Breath as a Tool for Sleep
Let’s take a step back to our ‘fight or flight’ response. Think about what happens to your body when you are stressed out. Your heart starts beating faster, you start sweating, and your breath becomes fast and shallow. These are not conducive conditions to going to sleep (3). So how can we counteract this and activate our PNS or ‘rest and digest’ response.
By breathing deeply into the belly (rather than into the chest) you will start to activate your parasympathetic nervous system. Try this exercise:
Ball one of your hands into a fist, squeezing as hard as you can. Now, take a breath into the belly, noticing your belly rising, and exhale slowly letting all of the air leave the body.
What happened during this exercise? My guess is that it got harder to keep your fist balled up as you took a deep breath. Your body naturally wanted to relax and let go of tension, all just from taking a breath!
Three Breathing Exercises to Try
If you’re ready to give breathing exercises a try, here are three exercises you can do before bed that will help you fall asleep and stay asleep. If possible, all of these exercises should be done breathing through your nose. However, as a chronic stuffy nose person, I know this is not always possible –– so if you are congested just breathe through your mouth! Aim to practice one or several of these breathing exercises for 10 minutes before bed.
The 4-7-8 Breath
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This popular breathing exercise is recommended by Dr. Richard Weil. Start by lying down in bed, and exhale all the air in your lungs. Then:
– Inhale for 1-2-3-4 counts
– Hold your breath for 1-2-3-4-5-6-7 counts
– Exhale for 1-2-3-4-5-6-7-8 counts
If this is too much of a challenge, you can reduce it so that it is the 4-6-7 or 4-5-6 exercise. As you continue practicing breathing deeply, your lung capacity will expand and you will be able to hold your breath for a longer time.
While inhaling can help give you a boost of energy, exhaling can help relax and activate the PNS. To do this exercise, lie comfortably in bed and inhale for 1-2-3-4 counts. Exhale for 1-2-3-4-5-6 counts. Continue this for several rounds, and then increase the exhales as you feel comfortable. Exhaling for 7, or even 8 counts.
Begin breathing deeply in and out of your belly. Notice what your breath feels like in the body, and the rhythm of your breathing. Once you are comfortable, begin counting the breaths. So inhale, then exhale and count one. Continue until 10, and then count backwards down to 1. Do this several times until you start to feel ready for bed.
Breathing exercises are not a fast-acting drug. While it is likely that you will get some results after one night of trying the breathing exercises, a long-term commitment to doing these exercises before bed will give you the most consistent results. You can also do exercises during the day to help you sleep better at night. Practicing a gentle exercise like yoga or tai chi during the day has been shown (4) to help patients with CFS and Fibromyalgia sleep better at night. Making an effort to breathe into your belly throughout the day will also help you stay more relaxed and primed for bed in the evening!
1. Rosane Nisenbaum, James F Jones, Elizabeth R Unger, Michele Reyes, and William C Reeves. A population-based study of the clinical course of chronic fatigue syndrome. Health Qual Life Outcomes. 2003; 1: 49.
2. Burton AR, Rahman K, Kadota Y, Lloyd A, Vollmer-Conna U. Reduced heart rate variability predicts poor sleep quality in a case-control study of chronic fatigue syndrome. Exp Brain Res. 2010 Jul;204(1):71-8.
3. Boneva RS, Decker MJ, Maloney EM, Lin JM, Jones JF, Helgason HF, Heim CM, Rye DB, Reeves WC. Higher heart rate and reduced heart rate variability persist during sleep in chronic fatigue syndrome: a population-based study. Auton Neurosci. 2007 Dec 30;137(1-2):94-101.
4. Sat Bir S. Khalsa. Treatment of Chronic Insomnia with Yoga: A Preliminary Study with Sleep–Wake Diaries. Applied Psychophysiology and Biofeedback. December 2004, Volume 29, Issue 4, pp 269-278.
Kayla is a yoga teacher, writer, blogger, and founder of Aroga Yoga(www.arogayoga.com). She helps people living with chronic illnesses find relief through yoga. Her goal is to make yoga accessible, so all of her programs are run online. People from all over the world can participate from the comfort of their living rooms. After suffering from CFS for most of her young adult life, Kayla is on a mission to help others live healthier and more fulfilling lives.