Fibromyalgia, Poor Sleep and Pain

Woman at night suffering from insomniaSome of the hallmarks of fibromyalgia are fatigue, feeling un-refreshed in the morning, and chronic widespread pain that affects muscles and joints.  Recent research out of the United Kingdom found that non-restorative sleep is tied to these fibromyalgia symptoms.  This was especially prevalent in adults over the age of 50.  Additionally, it was found that older adults with poor physical health, cognitive impairment, and anxiety were at greater risk of developing widespread pain.  The study was done out of the Arthritis Research UK Primary Care Centre at Keele University in Staffordshire and was published in Arthritis & Rheumatology.

From age 65 on, musculoskeletal pain seems to become a more common problem.  Musculoskeletal refers to anything that affects bone, nerves, and muscles.  In fact, about 4 out of 5 people over the age of 65 report having this type of pain on a daily basis.

This kind of widespread pain is not just limited to those over 65, however.  As mentioned, it is a common symptom of fibromyalgia, a condition that is also accompanied with excessive fatigue and long-term tender point pain all throughout the body.  Additionally, fibromyalgia patients have tenderness in joints, tendons, muscles, and other soft tissues.


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Fibromyalgia, Poor Sleep and Pain

Current estimations suggest that there are about 5 million Americans over the age of 18 that have fibromyalgia, and for some unknown reason the majority of them are women.  Fibromyalgia still affects men and children, however, just not as extensively.

Several factors have been linked to widespread pain development, this new study finds.  The research team out of Keele University identified key factors that increase risk and exacerbation of widespread pain such as that found in fibromyalgia and other musculoskeletal pain conditions in older adults.  There were over 4300 adults aged 50 and older that were analyzed in this study.  These patients did not have widespread pain at the beginning of the study, and 2700 people reported having some areas of pain, though not widespread.

This young woman is going through some tough timesPatients were asked to fill out questionnaires that asked them about their pain levels, physical health, mental health, lifestyle behaviors, underlying medical problems, and socioeconomical status.  These patients were followed for a period of three years and then re-assessed to look for widespread pain using the American College of Rheumatology Criteria.  Statistical tools were then used to analyze the data and look for factors that were most prominent in those who had the onset of widespread pain.

The results of this study found that 19% of patients had new widespread pain at the three-year followup visit.  This included 8% of patients who had no pain at the start of the study and 25% of patients who had some pain at the start of the study.

There is evidence in this study that links poor sleep to widespread pain.

Poor sleep refers to feeling un-refreshed in the morning, waking up frequently, having a hard time falling asleep, and suffering daytime fatigue and sleepiness as a result of poor sleep.  Occasional restless nights are common; however, it becomes a problem if you are experiencing this several nights a week over a long period of time.

The researchers that analyzed the data found that those who had either some pain or no pain, decreased quality of life due to physical complaints, anxiety, some cognitive impairment, and non-restorative sleep were the ones who reported new-onset widespread pain at the end of the study.

However, the most prevalent link to widespread pain was poor quality sleep.

This study out of Keele University, however, was not able to establish cause and effect, so it is impossible for the researchers to say that poor quality sleep causes fibromyalgia, or at least effects the symptoms.  However, as a physician who has treated fibromyalgia patients for nearly two decades, I can say without doubt that poor sleep absolutely has a negative impact on fibromyalgia.  Every patient who comes to me gets asked the same first question, “how is your sleep?”  Many of my patients actually feel several times better when we fix their sleeping pattern because that leads to better mood, higher pain threshold, and more energy.

I am happy that this study provides a clinical link to poor sleep and fibromyalgia.  There are many studies that have concurred these findings as well.  For example, Medical News Today reported in 2011 a study out of Norway that found women who had poor quality sleep were at increased risk of suffering from fibromyalgia.  This gives a deeper understanding to conventional physicians who are being overwhelmed with the increasing number of over-stressed patients presenting with symptoms so vague as to suggest they are psychosomatic.  This is a dangerous assumption, so perhaps these studies will add further understanding into the problem of fibromyalgia.

We are not able to determine which comes first, the poor sleep or the fibromyalgia; however, we do know that they are absolutely linked to each other because restoring sleep patterns immensely benefits fibro patients. 

Sleep disturbance, pain, and anxiety all combine to form a vicious cycle that repeats itself indefinitely until at least one part of the problem is fixed and breaks the wheel.

The medical director of the above study states that “research has also shown that aerobic exercise improves fitness and reduces pain and fatigue, and should also improve sleep and wellbeing.”  While this is true, restoring stress-coping hormones, serotonin levels, and all other hormonal and nutrition deficiencies will also be beneficial to anyone who is having trouble with sleep.

You can learn more about how to get a good night’s sleep without life robbing drugs, in my Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome book.

 


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