When a patient has fibromyalgia, sleep troubles are the last thing they need. Unfortunately, sleep problems affect a large number of fibromyalgia patients, and those problems can turn into a vicious cycle that interplays with daytime pain and fatigue.
Explore this issueJanuary 2018
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“Pain and sleep disturbances are a double-edged sword,” says Elika Kormeili, MFT, a licensed clinical psychologist in Los Angeles who helps treat patients with sleep problems. “The more pain you have, the more difficulty you have falling asleep and staying asleep. The less sleep you get, the more of a sleep deficit you have, which makes pain worse.”
“It’s been well documented that a lack of sleep lowers one’s pain threshold and magnifies pain perception,” says Inchel Yeam, MD, an internist at the MemorialCare Saddleback Medical Center in Laguna Hills, Calif., and board-certified in sleep medicine, pulmonary disease and critical care medicine. “Anything that increases pain in fibromyalgia patients could be detrimental.”
Lack of sleep also makes fatigue, cognitive and memory issues worse in those with fibromyalgia. And as sleep problems worsen—if, for example, a patient with fibromyalgia develops regular insomnia—anxiety and depression can develop or worsen, too, Ms. Kormeili says.
Fibromyalgia has had such a long-time link with sleep problems, it was once considered a sleep disorder, says Raj Dasgupta, MD, an assistant professor of clinical medicine at Keck School of Medicine of the University of Southern California in Los Angeles. That may not be the case anymore, but the two remain uneasy bedfellows.
There’s an increased awareness nowadays about sleep in general, and that’s prompting greater attention to sleep among those with fibromyalgia. “Most patients work hard, exercise and try to control their blood pressure, but there’s a whole eight hours at night that people forget [about],” Dr. Dasgupta says. “That’s why sleep is becoming more popular. More people are realizing that wellness is the big picture, and we need it at night and during the day.”
Diagnoses & Treatments
When a sleep specialist evaluates a fibromyalgia patient for sleep problems, they keep a few common problems in mind, such as obstructive sleep apnea (OSA). OSA is a common sleep disorder among fibromyalgia patients, says Robert S. Rosenberg, DO, the medical director at the Sleep Disorders Center in Prescott Valley, Ariz., and author of the book The Doctor’s Guide to Sleep Solutions for Stress & Anxiety. Snoring can be an easy tip-off, but sleep specialists will perform a sleep study and consider symptoms.