Dieting with Obstacles - fibromyalgia = sleep disorder ?

I saw my rheumatologist yesterday. She is treating me for my DJD, OA and fibro. I asked her about Lyrica but she said the insurance wouldn't cover it unless I tried another med. first. She also said she didn't want to prescribe it because I am already on enough meds that make me sedated because of my bipolar. Any way, she thinks fibro is a sleep disorder. I have to go for a sleep study. I do snore and my sleep is very disturbed. I do think I have a sleep disorder but I don't agree that fibro is a sleep disorder. Why would sleep problems cause fibro? Any other fibro sufferers ever heard this?

You can have a sleep disorder AND fibro - the two often go hand in hand. But I'm not aware of any study that says sleep disorders cause severe pain.
Doctors don't know how to treat chronic pain, so they come up with all sorts of lame excuses not to help you.
The latest theory about fibro, is that it is caused by problems in the central nervous system. Look up some medical articles and send them to your doctor. BTW you doctor sounds like a jerk.

I agree with my dr. being a jerk. But, I am having trouble finding someone who can help me with fibro. My primary dr. says it is symptomatic and you can't treat it. The rheuamatologist claims it is a sleep disorder. The only one who seems to have any kind of knowledge is my psychiatrist but he is limited to helping me with my bipolar and other mental issues not the physical things. He tried to prescribe Lyrica and the insurance wouldn't cover it because he is my psychiatrist not a medical dr.

I'd love to be able to find a good fibro dr.

I understand not being taken seriously - but don't listen to people who tell you it can't be treated.

There isn't a magic pill that is a cure all, but there are medications that can help. There are anti-depressants, anti-convulsants, etc.
Is there a research hospital near you? You can try to participate in a medication study - that's what I did.

Actually, there's quite a bit of evidence that disordered sleep can increase pain, and may be responsible for fibromyalgia in at lest a portion of cases. My neurologist said that sleep deprivations studies were attempted years ago, but the study was stopped because of the horrific side effects (pain, delusions, hallucinations...) He said sleep deprived rats do not survive long -- they die of immune disfunction - infections or autoimmune disease. So sleep deprivation is very serious.

My neurologist also believes that sleep quality is very important for fibromyalgia patients. He said he's not sure whether sleep disorders cause fibro, or whether the fibro causes the sleep disorder, but he strongly believes that fibro patients need to make sure they get good quality sleep. He tends to believe that the sleep disorder actually causes the fibro, because so many of his fibro patients have histories of sleep problems predating the fibro, often having a history of insomnia or "burning the candle at both ends." The latter was definitely my experience, as I had been working 60 hour plus work weeks, swing shifts, extra jobs, jobs with "on-call" responsibilities.... for about a decade before the fibro was diagnosed.

I had a sleep study done when I was first diagnosed with the fibro, and the study showed that I had sleep apnea and for some reason my brain never seems to enter the deepest most restful stage of sleep (also common in many fibro patients). I was prescribed the CPAP (the machine that pushes air gently into your nose or mouth). It really did help quite a bit. After I lost 40 lbs, the apnea went away, but sleep quality definitely plays a big role in my flares. When I'm flaring I need more sleep, and when I don't sleep well I get more flares.

It doesn't mean that restoring sleep function will "cure" your fibromyalgia, but it definitely can be an important part of treatment.

I will say that most of my flare ups also occur around the times i am struggling with my anxiety disorder. I do have disrupted sleep with the GAD and now that all of this has been brought up... i could definitely see a correlation between the two.

Both my GAD and Fibro were much worse when i was diagnosed with the Fibro 10 years ago and not seeking any treatment for the GAD.

I was also having flare ups when my husband and i moved in together (living in sin.. lol!) and he brought his bed into the apartment which was AWFUL and hard as a rock... i was having a horrible time sleeping and then i was stiff as stiff could be and so sore. Since we got a new bed for a wedding present last year, i have been feeling TONS better.

I go for the sleep study on 3/15. I will post the results for anyone who is interested.

I got the results of my sleep study yesterday. I have moderate to severe sleep apnea and I don't reach all the sleep stages. I have to go back next Saturday the 29th for another study. This time I will be hooked up to a CPAP machine.

I'd love it if this actually helps me get a good nights sleep. It has been so long since I have had a restful sleep - at least 3 years.

Please report back! I am very interested in what happens. I wish you a pain-free, restful time! :hug:

I got the results of my sleep study yesterday. I have moderate to severe sleep apnea and I don't reach all the sleep stages. I have to go back next Saturday the 29th for another study. This time I will be hooked up to a CPAP machine.

I'd love it if this actually helps me get a good nights sleep. It has been so long since I have had a restful sleep - at least 3 years.
Good luck! I hope this will help you. I know personally that my fibro flares most often when I'm sleep-deprived, so it would be fantastic if fixing the quality of your sleep will alleviate some of your pain!! Good luck!

My research has taught me that people with fibromyalgia do not get enough of what they call "restorative" sleep. So I tried several prescriptions to help me sleep better, and ended up on trazodone, which gives me restorative sleep. Others I've known who tried trazodone found they slept well but were too groggy the next day.

My mom and sister both have fibromyalgia and had the sleep studies and my sister is now on CPAP. She sleeps so much better as a result. Keep in mind that if the mask is uncomfortable there are other types of masks that can work, so speak up.

People with fibromyalgia are probably far more likely to have a sleep disorder of some sort, whereas people with sleep apnea (for instance) may not have FMS. I have FMS and also have sleep apnea & restless leg syndrome. I use a cpap and take meds.

I'm even more convinced that fibromyalgia is, or at least can be primarily a sleep disorder - particlulary sleep disorders that involve restorative sleep stages.

I'm now taking amitriptyline and cyclobenzaprine to get me into deep sleep. I'm having a lot fewer flares.

Linda, I just read your post and yes, I also have a sleep disorder that was originally believed to have caused my FM. I was diagnosed about 25 years ago with FM and the osteopath doctor I was seeing suggested that my interruptions of sleep patterns could result in the wide spread pain of FM. I owned a business that required me to get up every morning at 3 am...7 days a week, 40 weeks of the year. After 15 years of doing this, I had unexplained pain in every muscle of my body. I saw chiropractors, doctors and finally this osteopath who had just attended some sort of educational thing and he diagnosed me with Fibromyalgia....that was in 1984 when FM wasn't even acknowledged as a condition. There wasn't much in the way of treatments back then either so I took a lot of advil, had a lot of adjustments and indulged in biweekly massages. Since I sold the business 7 years ago, I have had "normal" sleeping hours yet the pain never subsided. That's when I found a sleep disorder doctor where I live (they are usually pulmonary specialists) and had a sleep study done. I have sleep apnea and now sleep with a CPAP machine that keeps my airway open all night so I get a sound sleep. I still have FM and so I am not convinced that a sleep disorder causes Fibromyalgia but I certainly believe it can trigger it's onset. The bottom line here is that I still have FM but at least I get a good night's sleep with it. I am going to assume that because you have a bipolar disorder, Cymbalta was not an option? Personally, I only take tramadol and aleve for my symptoms and just try to stay active. It's when I stop that I have the problems now. Old age??? Who knows but I just try to stay active. The sleep study will help with any sleep disturbance issues that a treatment of might help so I'd say go for it. Good luck with that.:)

Sleep disorders is one facet of fibro, then you have all the other symptoms, the constant pain in the joints, the foggy brain, the spasms in various body parts, the TMJ, depression and anxiety, and alot of other issues with it, and the cold affects me the worst, I was so much better with my fibro when I lived in Florida, I am moving back there, cause this cold weather makes it worse, I can barely get out of bed with my leg pains and back, and the new thing of being dizzy. I wish I could get rid of it, but I know part of it flaring up like it has, has been eating junk, so dieting and proper nutrition helps it alot. I don't sleep past 4 am, by that time I am so sore I need to get up and move.

Sleep disorders is one facet of fibro, then you have all the other symptoms, the constant pain in the joints, the foggy brain, the spasms in various body parts, the TMJ, depression and anxiety, and alot of other issues with it, and the cold affects me the worst, I was so much better with my fibro when I lived in Florida, I am moving back there, cause this cold weather makes it worse, I can barely get out of bed with my leg pains and back, and the new thing of being dizzy. I wish I could get rid of it, but I know part of it flaring up like it has, has been eating junk, so dieting and proper nutrition helps it alot. I don't sleep past 4 am, by that time I am so sore I need to get up and move.

and I

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Well, I have to say, that when I don't sleep well, my FM flares, but I don't have a sleep disorder. Just at times, I am so groggy all day, and wake up at bedtime. It's like my inner clock is messed up. If I take an Ativan for a couple of nights, I get good sleep and then am ok again for awhile. I never had a problem sleeping until menopause, and then FM happened along (diagnosed that is - think I had it for years). I also have arthritis, and I was watching some new info. on the news one night, and it also causes poor sleep quality. I have been walking around in a daze the past couple of days, but today, especially this afternoon, it seems to be clearing.

I live in Western Canada, where we have a dry climate. I love the cold because I feel good. When it warms up and snows, or rains, pain everywhere. It is the humidity that does me in.

I don't believe that FM is a sleep disorder, by it is part of the syndrome, along with IBS, Restless legs, pain etc. It is quite the package!!!

I think if comes from the upper cervical. After going to an Upper Cervical Chiropractor, both the arthritis and the FM started to improve by leaps and bounds, so much so, that after 10 years of not being able to do much, I was able to finally get back to working casual. I can't work fulltime, as I won't push myself to do that. I am just thankful that I learned of this type of chiropractor. There are not that many of them. Some of you might of heard of a fellow in the USA that does an ATLAS treatment. He travels all over and I believe he charged $200.00 for a one time treatment. Learned of this on an FM board. People said it really helpted them. If you want to learn more about this type of treatment go to www.nucca.org . It is so worth it.

Well, I have to say, that when I don't sleep well, my FM flares, but I don't have a sleep disorder.

Unless you've had a sleep study, you could easily have an undiagnosed sleep disorder. Many sleep disorders are impossible to diagnose without a sleep study that includes an EEG (just testing for apnea, or for RLS isn't enough - you have to test for apnea, RLS/PLMD, and sleep stage disorders).

Sleep disorders are so common in fibromyalgia (up to 80%), most especially the alpha EEG anomoly, that more and more they're considered most likely a cause rather than a symptom (because if you artificially induce such a sleep disorder, you would get symptoms identical to fibromyalgia).

Before I had my first sleep study (before I was diagnosed with fibromyalgia, in the process of trying to find a diagnosis for my strange symptoms), I would have told you that I didn't have a sleep disorder either (at least until I was sleeping far more than normal). As it turns out I had several (and now have one less as the sleep apnea disappeared after I lost only about 35 lbs), and probably had most of them for years before I had any inclination that my sleep wasn't normal.

Lucid dreaming for example, I've had in some form for as long as I can remember. As a child I had no idea that my dreams were any different than anyone else's. In lucid dreaming a person is aware or at some point in the dream becomes aware that they are dreaming and can control, to some extent, the events of the dream - or may be able to choose to wake up. I was rarely afraid of nightmares as a child, because in the dream I would choose to alter the course of the dream when it got scary - or reassure myself in the dream that it wasn't really scary because it was a dream, and if all else failed I could choose to wake up.

Waking from a (seemingly) normal 7 to 10 hours of sleep, feeling less-than-refreshed was probably an early sign of one or more of the sleep disorders. That was a problem since high school (when fibro symptoms also started to appear, though I wouldn't have a fibro diagnosis for another 25 years). I always attributed the morning (and later constant) fatigue to my over achievement (I graduated high school and college early, and always took extra class loads and took as much work-study and paid work as I could (often swing shift work). After graduate school, I also usually worked two jobs, often swing-shift work, until the worsening fibro symptoms made that impossible).

Both a rheumatologist and a neurologist told me that my years of burning-the-candle-at-both-ends, may have triggered the sleep disorders/fibro - as they've also recently found a link between swing-shift and double-shift workers and fibromyalgia and sleep disorders.


Anyway the sleep disorders my sleep study found:


Sleep Apnea I wa having 90 episodes of apnea per hour. I was prescribed a CPAP machine, which greatly reduced the fatigue and even the severity and frequency of pain flares. The sleep apnea disappeared after I lost about 35 lbs. I no longer use a CPAP, although (now that my husband knows what apnea sounds like) I do periodically have flares of the sleep apnea if I have a severe respiratory infection (when I've had bronchitis or pneumonia).


Restless Leg Syndrome and Periodic Limb Movement Disorder, which is considered one diagnosis or two depending upon which doctor you talk to. PLMD is a more severe form of rls where the whole body, not just the legs are affected. Basically if I'm not taking my medication for it, my husband will wake up with bruises from my thrashing around. (Very common to fibromyalgia, but not nearly as much so as the alpha EEG anomoly).

Alpha EEG Anomaly Alpha EEG anomaly occurs when sudden bursts of brain activity occur during a time when the brain should be in deep sleep. This is the most common of sleep disorders in fibromyalgia (in most studies looking for it, it's been found in more than half - sometimes much more than half of fibro patients studied).

This can take two forms (again one diagnosis or two? I have both)

1. Brain waves associated with "awake states" intrude and interupt deep. My sleep study revealed that I spend nearly no time in deep, restorative sleep. I wake or return to shallow stages of sleep almost immediately upon entering REM (as a result, I spend nearly no time in deep restorative sleep).

2. Brain waves associated with "awake states" occur simultaneously during deep (REM) sleep. A person can seem to be both awake and asleep simultaneously

Two examples of what I believe to be manifestations of #2, which I experience frequently are sleep paralysis, and lucid dreaming (being aware that one is dreaming, during a dream, and being able to a degree to control the dream - one type that I have that is very unpleasant is knowing that I am dreaming, but being unable to wake up, sometimes dreaming that I am waking repeatedly only to find it yet another dream. I can panic in the dream, feeling I will not be able to awaken).

i have to agree that fibro and sleep disregulation go hand in hand. interestingly though, my pdoc told me that roughly 80% of ppl with bipolar also have fibro (i have both). i find that when my moods cycle, especially downwards, my pain levels rise and i have to be extra vigilant on having a regular bed time and rise time. i find that even if i can't sleep, the key is being in bed, taking some time to yourself before trying to sleep, and that it's more important to rise at the same time each morning then going to bed at the same time.
Just some things that have helped me over the last 12 years of pain-
Diet is *so* important. when i was properly diagnosed and being treated as an inpatient the hospital cafs at the time were abundant with unhealthy choices and i not only gained weight, but my pain levels got worse. i started reading about nutrition and quickly cut out things like junk food and soda. something important i read about diet was that if your ancestors would not have recognized it as food, you shouldn't be eating it. i find when i eat according to that philosophy i feel best.
also i'd recommend getting tested for food allergies. what might be a sensitivity to wheat or dairy can present itself in hightened pain levels, disturbed sleep and mood. this helped me tremendously.
it's *so* important to move. walking and yoga and stretching and light weight lifting are very important. i've had periods of time where i was bedridden or had to stay in a wheelchair and the hardest thing to do is get moving again.
and, of course, finding not only a good doctor, but one who BELIEVES you and listens to you.

Hi Linda!
I've been diagnosed with fibro for a little over two years now. I'm not sure I agree with Fibro being a sleep disorder but I do believe extreme fatigue is a big part of Fibro. I recently stopped taking Lyrica I had been taking it for a little over a year. When I was taking a low dose of 50mg I did notice a difference in my pain but eventually it was not working as well. He then tripled by dosage to 150 mg and i felt like i was hitting a wall. All I wanted to do was sleep. I stuck it out for a few months but eventually he took me off because I was gaining more weight an I was just so extremely exhausted. Everyone is different, if you do start taking lyrica I hope it starts working for you and doesn't make you more tired. :)

I haven't always slept perfect. However, I know for a fact that my sleeping habits have gotten much worse after I started dealing with Fibro. My bowels have also gotten worse. I don't think the fibro is getting worse but because of these other problems that have arisen from this illness it seems to feel so much worse.

I am not a doctor but I am sure I was lacking sleep long before I had Fibro. I also have UCTD so what the heck...I don't even know anymore!

I had sleep deprivation 15 years before I had a fibro diagnosis, and 5 years before I had fibro symptoms.

I think fibro is a "cascade" disease, meaning that there may be several ways to get here, but once you get it, it becomes self-perpetuating, even self-worsening.

The starting point may be anywhere in the cycle.

Maybe for some people, it starts with poor sleep (I think for me, it did).
You don't sleep well, and the sleep deprivation causes increased pain and fatigue. The increase pain makes it harder to sleep well. The sleep deprivation causes more pain and fatigue, which further disturbes sleep.

For some, maybe it starts with pain. They have pain, so they don't sleep well, so they have more pain and fatigue, which causes more sleep problems, which causes more pain and fatigue problems.

There may be a thousand ways to get onto the pain/fatigue/sleep/other weird symptom rollercoaster, but regardless of how you get on the downward spiral, it's still very hard to stop the downward trend, and even harder to get off the spiral completely.

Slowing and even reversing the spiral is possible, but I'm not sure getting off, ever is.

Obesity can be a spiral like that too. Gaining weight makes it harder to do the things that get the weight off, which makes weight gain easier, which makes it harder to do the things that get the weight off...

Spirals do work in reverse too, but the uphill battle is so much more difficult, because it takes conscious effort. The downward spiral doesn't seem to need much of a push to get started.

I think a lot of things contribute to my fibro and the related stuff (IBS and such), and to my obesity too. It's just really hard to reverse the trends. Especially when things affect the spiral that you have no control over.

Weather has become a big trigger for me, and tough luck, that's not something I personally can change. Sleep deprivation is a big trigger for me, and I don't have full control over that. Diet is a big trigger for me, and that I have complete control ever, except when I don't (the worse I feel, the less able I am to make good decisions. So I have to have plans in place, and try to make habits that are so ingrained, that even on a bad day, I stick with them.

I suspect there are so many causes of fibro that a "cure" will be a very long time in coming. I think fibro is like a collander. You can plug one hole, but but you'll still have dozens to go.

Treating fibro is a personal journey of finding all the holes that contribute to your flares. But if the flares are really bad, and nearly constant, you never have the strength and energy to seek out the holes in need of patching (let alone having the strength and energy to actually do the repair work, and to make matters more interesting, many of the repairs only work temporarily, so you'll have to often refill the same hole over and over again).

Fibro is exhausting. Managing fibro is exhausting.

I've got ME/CFIDS rather than fibro, but there's huge overlap and they're probably related, so I thought I'd chip in. My sleep disorders started when the ME did and got worse over time, especially once I became housebound and stopped getting proper signals from light and darkness. When I haven't slept well, various symptoms are noticeably worse, especially pain and grogginess.

I have circadian rhythm disorders, Delayed Sleep Phase Syndrome which progressed into Non-24 Sleep-Wake Disorder. I managed to get a handle on the N24 using bright light therapy, at which point it reverted to DSPS. A few years later, I discovered that darkness therapy controls the DSPS, and have been doing a lot better since then. Certain things have improved a fair amount, and my lifestyle is certainly easier now that I'm sleeping at normal hours, but the ME is by no means cured and has continued its pattern of steady deterioration alternating with stable periods.