How Does Fibromyalgia Affect Sleep? Get Better Sleep When You Have Fibromyalgia Update 06/2024

As the name suggests, fibromyalgia is a long-term condition that causes widespread pain and stiffness in the joints and muscles. Fibromyalgia affects around 4 million persons in the United States. There is no cure for this disease, but the symptoms can be controlled and even reversed with the right combination of medicine, therapy, and dietary modifications.

Fibromyalgia patients often have trouble sleeping as one of their many symptoms. The disorder’s symptoms can be exacerbated by sleep difficulties in certain persons, leading to a vicious cycle of agony and sleeplessness. It is possible to alleviate fibromyalgia-related sleep disorders by practicing proper sleeping hygiene and developing healthy sleep habits.

How Does Fibromyalgia Affect Sleep?

Because of their lower pressure-pain threshold, those with fibromyalgia are more sensitive to pain than those who do not have this condition. “Abnormal pain perception processing” is the medical term for this. This notion appears to be supported by neuroimaging studies, which show that patients with fibromyalgia and healthy, non-affected adults have similar brain activation.

Fibromyalgia sufferers frequently experience sleep disturbances and daily exhaustion. According to certain polysomnographic data, people with the disease are more likely to wake up during the non-rapid eye movement (NREM) stages of the sleep cycle and hence get less slow-wave sleep.

Fibromyalgia and sleep are linked in a reciprocal manner. Sleep deprivation can increase the broad feelings of pain and tenderness that are brought on by fibromyalgia, just as unpleasant symptoms can prevent patients from getting adequate rest. Sleep deprivation can also reduce a person’s tolerance for discomfort. Therefore, in otherwise healthy individuals, fibromyalgia symptoms may be brought on by sleep deprivation or poor sleep quality.

The vast majority of fibromyalgia sufferers are in their forties and fifties. Fibromyalgia affects about 80% of women and 10% of men. Some medical conditions, such as rheumatoid arthritis, spinal arthritis, and lupus, can enhance one’s likelihood of acquiring fibromyalgia symptoms. In addition to insomnia and restless legs syndrome, fibromyalgia has been associated with both of these sleep problems.

Fibromyalgia and Insomnia

Chronic trouble falling or staying asleep, despite having the means and chance to get enough sleep each night, is the hallmark of insomnia, a sleep disorder. As a result of their insomnia, many people also suffer from weariness, mood swings, and a lack of enthusiasm and energy.

Fibromyalgia patients frequently suffer from insomnia. A fibromyalgia diagnosis is often made on the basis of symptoms such as insomnia, exhaustion, and insufficient restorative sleep. Fibromyalgia symptoms can worsen if you don’t get enough sleep, which lowers your pain threshold.

Patients with insomnia may benefit from cognitive behavioral therapy for insomnia (CBT-I), a scientifically proven treatment method that aims to identify and address the underlying thoughts, feelings, and behaviors that are causing their insomnia. Gray matter atrophy in the central nervous system is frequent in persons with fibromyalgia, and CBT-I has been shown in one research to halt or reverse it.

The impact of fibromyalgia-related broad pain on the effectiveness of a sleep drug was also examined in this study. While taking suvorexant (licensed for insomnia treatment), fibromyalgia patients slept longer and reported less discomfort the following day than those who received a placebo.

Consider CBT-I, medication, or other therapy methods to alleviate the symptoms of both insomnia and fibromyalgia if you suffer from both.

Fibromyalgia and Restless Legs Syndrome

Known medically as Willis-Ekbom illness, restless legs syndrome (RLS) is a sensorimotor ailment marked by an incessant need to move or adjust one’s limbs.

When RLS sufferers are laying down or sitting in bed at night or in the early morning hours, they are more likely to experience unpleasant symptoms. Temporarily relieving symptoms with exercise or stretching is possible, but it is common for them to return as soon as the person’s body settles back down.

Fibromyalgia and RLS appear to share many symptoms. Some people may be misdiagnosed with fibromyalgia after displaying RLS symptoms, or the other way around. This is because both disorders are connected with sensory abnormalities. RLS sufferers may find relief by addressing underlying medical issues.

Diagnoses & Treatments

obstructive sleep apnea is one of the most common issues that a sleep specialist looks for while evaluating a fibromyalgia patient’s sleep issues (OSA). Robert S. Rosenberg, DO, the medical director of the Sleep Disorders Center in Prescott Valley, Arizona, and the author of The Doctor’s Guide to Sleep Solutions for Stress & Anxiety, says OSA is a prevalent sleep issue among fibromyalgia sufferers. Snoring can be a simple indicator, but sleep specialists will do a sleep study and look at other symptoms to determine if a person has a sleep disorder.

Dr. Rosenberg says she sees an increase in the prevalence of upper airway resistance syndrome in women with fibromyalgia, which is another common OSA variant. They “wake up,” he explains.

There are certain individuals with fibromyalgia who are not tested for OSA, but Dr. Dasgupta is aware of this. A fibromyalgia patient who gets seven to eight hours of sleep but doesn’t feel rested is a good candidate for an OSA screening, according to the doctor.

Doctors routinely use a CPAP mask to treat sleep apnea. Dr. Dasgupta tries to reassure patients that CPAPs aren’t as bulky as they’ve been made out to be. According to him, “CPAP use requires a mask, but not all of them look like Darth Vader.” Positional therapy, a dental appliance, or even surgery to remove tonsils can also help some patients with OSA avoid CPAP use. As Dr. Rosenberg puts it, “Most of the older [surgical procedures] are not successful, but there is still a place for some individuals.

According to Dr. Dasgupta, sleep specialists often advise individuals with OSA to lose weight and exercise if necessary. Obesity, cardiovascular disease, and diabetes are common co-existing conditions in patients with OSA. He adds that doctors must also determine if the patient is on any other medications that could exacerbate their breathing problems or if they have previously been diagnosed with OSA.

Dr. Rosenberg believes that treating OSA in people with fibromyalgia is beneficial. Fatigue is reduced greatly and discomfort diminishes as a result of treatment. It’s easier to fall asleep, there are long stretches of REM sleep, and the body produces more growth hormone.”

According to Dr. Dasgupta, restless leg syndrome (RLS) is common among fibromyalgia patients, especially iron-deficient women and women of childbearing age. According to him, doctors diagnose RLS in about half of all fibromyalgia patients. Twitching in the legs is one of the most common symptoms, and it’s worse at night and when you’re sleeping. When it comes to sleep, even though RLS isn’t formally classified as such, it might cause sleep issues. To ignore the symptoms, Dr. Rosenberg explains, “it’s not uncommon for clinicians to suggest it’s fibromyalgia pain”.

An iron shortage, kidney difficulties, or untreated diabetes may be the fundamental cause of RLS, which can be treated with medicine. Treating RLS can alleviate the symptoms of fibromyalgia, much as treating OSA did.

Fibromyalgia patients are frequently plagued by insomnia. Insomnia is treated by Ms. Kormeili using cognitive behavioral therapy (CBT), which she is a qualified insomnia therapist. When it comes to sleep issues, “Cognitive behavioral therapy focuses on changes in ideas and actions,” she explains. Fibromyalgia sufferers can benefit from cognitive-behavioral therapy (CBT) for insomnia.

Laughter yoga and even gratitude exercises are two of the many techniques she employs in her practice. She adds that CBT can also help individuals gradually decrease their need for sleeping drugs.

Patients with fibromyalgia can benefit from the expertise of both sleep specialists and rheumatologists in addressing common sleep issues, such as:

  • Keeping track of one’s sleep patterns and occurrences of sleep problems;
  • Being physically active on a regular basis
  • Using the bed only for sleeping; adhering to a regular and consistent sleep routine;
  • meditating and relaxing using several methods.
  • The use of electronic gadgets and light at night should be reduced or eliminated.
  • Making an effort to sleep with melatonin, a natural sleep aid; and Choosing to see the bright side of things.

According to Ms. Kormeili: “When we are sad or stressed or sleep-deprived or in chronic pain, we see the world through dark, gloomy glasses and tend to overlook things that are going right.” Gratitude awareness exercises, as she’s discovered, work exceptionally effectively for fibromyalgia people.

What About Sleeping Pills?

Both rheumatologists and sleep medicine specialists advise against the use of sleeping medications as a means of promoting restful sleep. Electroencephalography (EEG) shows “strange signals” when people use too many sleeping drugs. Dr. Yeam argues that long-term usage of sleep medicines has led to an increase in accidents and early dementia.

Fibromyalgia patients, according to him, are more likely than the average population to be exposed to doctors and pharmaceuticals, which might lead to a greater interest in finding ways to improve sleep through medications and gadgets. This might lead to bad behaviors and preconceptions about how to get a good night’s rest, he says.

Rebound insomnia is a common side effect of long-term usage of any sleeping drug.” As a clinical director and founder of the Columbia University Lupus Center in New York City, Dr. Anca D. Askanase believes it is better to avoid or use them on a short-term basis. “I feel it is best to avoid them or use them on a short-term basis,” says Dr. Askanase.

It’s critical, adds Dr. Yeam, in addition to the aforementioned treatments, to educate patients on the importance of getting a decent night’s sleep. It’s “one of the myths I’d like to dispel” that there is a “perfect slumber,” adds the author. There is no “perfect” sleep, as defined by most individuals. There are different stages of sleep, which is an active state. The brain does not go into hibernation or sleep. The brain’s various regions are working at full capacity.”

As a result, sleep-wake cycles occur often at night. “Sleep isn’t flawless,” he says. As we awaken, we toss and turn. According to him, this can be found in “regular, healthy sleep.”

How Can You Help?

Patients with fibromyalgia or any other rheumatological ailment may find that their rheumatologists are unable to spend much time helping them sleep better because they are already overworked. According to sleep specialists, there are a few things they may do to get the conversation started. Make sure your fibromyalgia patients are evaluated by a team of health specialists to offer the best possible care. Dr. Askanase explains that in addition to their main care physician and rheumatologist, people with fibromyalgia need to see a psychologist, a physical therapist, a psychiatrist, and a sleep specialist for their treatment. “Good outcomes in fibromyalgia need an understanding of the need for a collaborative approach.”

The STOP-Bang and Berlin online questionnaires can also be helpful in OSA evaluation. As a waiting room test, it takes around four minutes and can help diagnose OSA. That includes your medical assistant,” Dr. Rosenberg claims. Sleep specialists may be referred to those who complete surveys like this one.

When examining a patient, consider asking a few short questions on sleep as an alternative to the questionnaire. It’s a simple question that Dr. Dasgupta advises. Dr. Rosenberg says you can also inquire about the patient’s sleep habits, including how often they wake up during the night and how much time they spend in bed.

Finally, seek advice from a sleep professional as soon as possible. Many rheumatologists and neurologists, according to Dr. Rosenberg, overlook or misunderstand a patient’s RLS symptoms because they don’t ask about sleep problems.

There is hope for those suffering from fibromyalgia who take a more holistic approach to their sleep hygiene.

Sleep Tips for People With Fibromyalgia

It is possible to alleviate the symptoms of fibromyalgia by getting adequate sleep. There is, however, a problem with it. Fibromyalgia patients’ inability to get a good night’s sleep could be explained by a disruption in the typical sequence of brain waves. As a result of your brain’s wakefulness-signaling waves interfering with your deep sleep, you never truly fall asleep. In order to receive the rest you need, what options do you have?


Some fibro drugs target the pain that keeps you awake at night, while others may improve the quality of your night’s rest. You may be able to sleep better and longer if the medication is available in an extended-release form.

However, not everyone is treated by the medication or is helped enough.

Other Conditions

People with fibromyalgia are more likely to have a sleep disturbance than those without the condition. Restless leg syndrome (RLS) is the most common cause for them (RLS). If you suffer from both diseases, you may find it difficult to stay awake during the day. RLS can be treated. When you have sleep apnea, your breathing is disrupted, which can be life-threatening. Because fibromyalgia sufferers’ sleep issues are so similar, researchers are investigating if treatment for sleep apnea can assist, even if the patient does not have an apnea diagnosis.


Fibromyalgia treatment requires regular exercise, but the timing is critical. Exercise during the day can help you get a better night’s sleep. You may be unable to fall asleep if you engage in strenuous activities within three hours of going to bed.

You may find that exercising in a pool is less difficult because the water acts as a cushion for your joints.

Taoism is a mind-body practice that combines meditation with slow, deliberate movements and deep breathing. Better sleep, less discomfort, and reduced stress are all possible outcomes.

Soothing Sounds

Taking a bath and listening to music before going to sleep can help you sleep better. In four-week research, those with fibromyalgia could change the volume, length of time they listened, and even replay it if they woke up in the middle of the night. Music to Promote Sleep, on the Sonic Aid label, was picked for its particular beats, and everyone heard it.

Cognitive Behavioral Therapy

The brain may be a strong tool for health and well-being Cognitive behavioral therapy, sometimes known as CBT, aims to help you improve your way of thinking.

It’s possible that fibromyalgia-related sleeplessness can be helped with cognitive-behavioral therapy (CBT). Many people fear that they won’t sleep because of their discomfort, which in turn makes the pain worse so it’s more difficult to sleep. This can be especially beneficial if you’re locked in a negative thought spiral.

Healthy Sleep Habits

As a result of seeing a sleep specialist for insomnia, you learn about excellent sleep hygiene, which are behaviors that might help you sleep better. Taking these simple actions can help alleviate pain and exhaustion and enhance your sleep.

Prioritize sleep and stick to a sleep routine. Every day, regardless of the weekend, go to bed and rise at the same hour.

Create a peaceful atmosphere in your bedroom. Chronic pain can be exacerbated by loud noise, such as a blaring television. Maintain a cool, peaceful atmosphere. You deserve a good night’s sleep on a good mattress and sheets.

It’s best to avoid taking daytime naps because they can interfere with your ability to sleep at night. Take a 60-minute siesta if you must, but get up and go right away.

The evening is a time to abstain from stimulants like coffee and tea, as well as booze. To avoid waking up to use the restroom, it’s a good idea to stop drinking any liquids a few hours before going to bed.

Stay away from nighttime activities that keep your mind racing, such as working till the wee hours or binge-watching a gruesome thriller. At least an hour before the lights go out, turn off all electronic devices. After that, relax with a hot bath or a few deep breaths.

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