Fibromyalgia and the Importance of Sleep

            One of the most frustrating symptoms of fibromyalgia (FM) is the inability to get a good night’s sleep! Recently, at an Harvard-sponsored conference on the subject of pain, it was stated that “…no one should have to live in constant pain with what is known about pain management in this day and age (paraphrased).” Many attendees agreed that improving sleep quality may be the #1 way to improve the quality of life for patients with widespread pain. So the question is, what can be done to improve the sleep cycle for all of us, not only the fibromyalgia patient? Let’s take a look!

            The importance of sleep has long been discussed as being not only key in managing the FM patient, but some experts even suspect it's the probable cause of the disorder itself. It has been found that we must get at least four hours of continuous sleep in order to reach a deep sleep stage, and only at this level of sleep can we fully relax. If we can’t get to that deep sleep stage, our muscles (and mind) can’t fully relax and over time, the gradually increasing tightness may result in pain and the vicious cycle continues to chip away at the quality of life of the FM patient.

            Exciting new research from the United Kingdom reports that for those over age 50, non-restorative sleep – the type where you wake up tired, foggy, and listless - is STRONGLY tied to widespread pain, the “hallmark” of FM. The researchers also report that anxiety, memory loss, and poor physical health are linked to widespread pain in older adults. In the journal Arthritis & Rheumatology, author Dr. John McBeth wrote that musculoskeletal pain becomes more common with aging and affects four out of five seniors on a daily basis! Widespread pain is a KEY FEATURE of FM, which also includes fatigue and tenderness in muscles, joints, tendons, and other soft tissues. It is estimated that about 5 million American adults are affected by FM with women being affected four times more often than men (for reasons unknown). FM can occur insidiously (for no known reason) or secondary to an injury or illness.

            After studying a group of 4,300 adults (> age 50) of which 2,700 had some pain but not widespread pain, Dr. McBeth and his colleagues found several factors that can increase an older individual's risk of developing widespread pain. At the start of the study, participants completed questionnaires about pain, mental and physical health, lifestyle and health behaviors, medical conditions, and more. After three years, they were reassessed in a similar manner and 19% reported NEW widespread pain. This included 25% of participants who initially reported some pain and 8% who reported no pain at the study’s start. The most important link for the development of widespread pain was non-restorative sleep. Other links included pain status, anxiety, physical health-related quality of life, and some form of cognitive complaint (such as memory loss). They also note that brainwave studies of FM sufferers often show the inability to reach deep sleep. Moreover, in an experiment where healthy volunteers were woken during each period of deep sleep, a number of them soon developed typical signs and symptoms of FM!

            Chiropractic care includes treatment methods that reduces pain and muscle spasm and as a result, frequently improves an interrupted sleep pattern. Doctors of chiropractic are also STRONG ADVOCATES of home exercise and typically offer in-office training. Before attempting drugs with significant side effects, you owe it to yourself to include chiropractic care in your FM management “team!”