Fibromyalgia (FM) affects the entire body, which makes the diagnosis challenging! A VERY common issue with patients struggling with FM includes problems related to sleep. This goes beyond the number of hours one “tries to sleep” but rather the quality of sleep and feeling “restored” in the morning. That is, quality is more important than quantity! Let’s look further…

1. Common sleep problems: Insomnia, or difficulty falling asleep, as well as frequent awakenings to the point of recalling being awake during the night are common with FM. Even more common are instances of waking up during the night but being unable to remember it in the morning. This interrupts “deep sleep” and poses an even more important issue. Common sleep disorders associated with FM include restless leg syndrome and sleep apnea. The goal of sleep is to feel restored when waking in the morning. Sleep deprivation can also be caused by pain, depression, and anxiety, all of which are associated with FM.

2. Restless Legs Syndrome (RLS): RLS is considered a neurological disorder that usually occurs at night and at times during the day when the body is inactive. It is characterized by an overwhelming urge to move the legs when they are at rest.

3. Sleep Strategies: Developing better sleep “hygiene” is important in the management of FM. This can reduce pain, fatigue, the “fibro fog” and in turn, reduce anxiety and depression. Here are some effective ways to accomplish a better sleep pattern:

• Though this sounds counterintuitive, sleep ONLY as much as needed to feel refreshed. Excessively long periods of time in bed can lead to fragmented and shallow sleep.
• Keep a diary to log how much you sleep each night, when you went to bed and woke up in the morning, when and what you last ate/drank prior to bedtime and any other “triggers” you can think of that may have interrupted your sleep. Follow the “best” pattern!
• Try to go to bed at night and wake up in the morning at consistent times, once you determine the “best” pattern. This will strengthen your circadian rhythms and facilitate sleep quality.
• Practice relaxation techniques such as gentle massage, deep breathing, and relaxation recordings to enhance restorative sleep. Soak in a hot bath or shower prior to going to bed.
• Exercise regularly to enhance sleep quality.
• Sound machines can help those accustomed to noise, as loud noises can disturb sleep, even if it’s not remembered in the mornings. Keep the room dark and/or use a sleep mask.
• Avoid long daytime naps, as they can interfere with nighttime sleep.
• Keep the bedroom temperature cool, as too much heat is sleep disturbing.
• If you are hungry at night, a light carbohydrate rich snack may help you sleep.
• Avoid nicotine, alcohol, or caffeine in the evenings as they interfere with sleep.

4. Medication and nutritional aids: First, try herbs like valerian root, hops, ginger, turmeric, boswellia, amino acids like melatonin, 5-HTP, tryptophan, magnesium, and/or kava as NONE of these are habit forming. Your doctor of chiropractic can help you with this decision! If the herbal/nutritional approaches are not satisfying, he or she can refer you for a medical consult for prescription options.