In turn, there’s frequent switching at night from sleep to brief wake modes. “Basically, sleep is not perfect. We wake, toss and turn. This is found in normal, healthy sleep,” he says.
How Can You Help?
Naturally, many rheumatologists are already swamped and can’t devote too much time to helping patients with fibromyalgia or any rheumatological condition sleep better. However, there are a few things they can do to start the discussion, according to sleep experts.
First, to ensure the best care for your fibromyalgia patients, make sure a team of health professionals evaluates them. “The care of fibromyalgia patients includes skilled professionals, a psychologist, a physical therapist, a psychiatrist and a sleep specialist, in addition to the primary care physician and rheumatologist,” Dr. Askanase says. “Understanding the need for a team approach is critical to good outcomes in fibromyalgia.”
Next, short questionnaires online, such as the STOP-Bang and Berlin, can help OSA evaluation. “If you have patients fill it out in the waiting room, it takes about four minutes and helps identify OSA. Even your medical assistant can give it,” Dr. Rosenberg says. Such questionnaires may help determine who needs a referral to a sleep specialist.
In addition to a questionnaire, you can ask some simple sleep questions when evaluating a patient. “How are you sleeping?” is an easy one Dr. Dasgupta recommends. You can also ask about how much sleep the patient is getting, and how many times they wake up at night, Dr. Rosenberg says.
Finally, consider referring to a sleep specialist sooner rather than later for help. Dr. Rosenberg says he’s surprised by the number of rheumatologists and neurologists who don’t ask about sleep issues at all, and who tend to ignore or mischaracterize a patient’s RLS symptoms.
With a bigger picture approach to sleep quality, fibromyalgia patients can improve their symptoms and quality of life.
Vanessa Caceres is a medical writer in Bradenton, Fla.
References
- Gray SL, Anderson ML, Dublin S, et al. Cumulative use of strong anticholinergics and incident dementia: A prospective cohort study. JAMA Intern Med. 2015 Mar;175(3):401–407.
- Hansen RN, Boudreau DM, Ebel BE, et al. Sedative hypnotic medication use and the risk of motor vehicle crash. AJPH. 2015 Aug;105(8):e64–e69.
