By: Dr. Zachary Fellows

Sleep! It’s that blissful, restorative state we all crave at the end of a long day. Yet, for many, a good night’s sleep is as elusive as a dream. This is especially true for those suffering from fibromyalgia or centralized pain otherwise, and, to the surprise of some, it’s that missing sleep that might be aggravating your pain.

I’ve often felt that and described centralized pain more as a spectrum that we live on, for example we all start out near the beginning of a line where we don’t have any or maybe just very little centralized pain. Push the wrong levers over time and move the needle down the line? Pain increases. Sleep, in my opinion, is one of the most common culprits that pushes that needle down the line, down the spectrum towards fibromyalgia and in many cases makes all of our pain (and moods!) worse.

The Sleep-Fibromyalgia Connection

There’s a staggering, estimated rate of 70% of fibromyalgia sufferers that struggle with insomnia. That’s an immense figure and points to a deeply intertwined relationship between sleep quality and fibromyalgia. The question often arises: is this a mere coincidence, or is there a deeper, causative link?

Consider this analogy: enduring insomnia is akin to bearing the weight of a chronic ailment or undergoing continuous emotional stress. It’s manageable in the short term – we can all handle a brief illness or a temporary financial hiccup. However, when that illness extends to months, years even, or those financial struggles become severe, relentless, and there’s no answer in sight for months, years – these things hit us quite differently. Sleep deprivation is the same, if it extends over weeks, months, or even years, its impact is profoundly different on our bodies. This constant, unrelenting strain on mental and physical well-being nudges us down the fibromyalgia spectrum, either possibly triggering its onset and at dead minimum exacerbating existing symptoms.

A Path to Better Sleep

So, what can be done?

The first answer lies in the basics that we all know or have heard at one point – sleep hygiene. It’s a concept we intuitively understood as infants and observed as parents. For those of us with kids, remember setting a quiet environment for a child to sleep? A dark, quiet room, free from distractions – this principle remains equally vital for adults. We can’t turn on a loud movie, turn the lights on, and drink a pot of coffee before bedtime and expect our body not to fight us as we go down!

Start with these easy tips at home:

  1. Darken Your Bedroom: Invest in blackout curtains, especially if you’re a night-shift worker. Darkness cues our brain that it’s time to wind down.
  2. Disconnect from Electronics: Put away those cell phones and gadgets at least an hour before bed: any blue light emitted from screens hinders the production of melatonin, our natural sleep hormone, disrupting our sleep cycle.
  3. Establish a Consistent Sleep Schedule: Our bodies thrive on routine. Setting a regular bedtime and wake-up time synchronizes our internal clock, aiding in better sleep quality.
  4. Mind Your Intake: Caffeine and nicotine are stimulants that can disrupt your ability to fall asleep. Consider avoiding caffeine late in the afternoon and steer clear of smoking, especially before bedtime.
  5. Address Pain Proactively: If pain is a barrier to comfort, explore both non-medication and medication strategies with your doctor to ease into sleep more effectively (this would be highly specific to your situation and what your pain is from!)

When sleep hygiene fails, and sadly it often does, we build on it. Cognitive behavioral therapy (CBT) is a therapy strategy often administered by a psychologist or therapist who is trained in using CBD for fibromyalgia patients! To get to the root of what’s keeping your mind from slipping into a restful sleep. One estimate at how effective CBT is puts it as effective as Ambien for anyone who may have treaded down that path before! Medications, like doxepin, trazodone, Ambien, Belsomra, and many others exist as well and might be helpful for some to help grab short-term control of one’s sleep until we can get into a better, sustainable sleep habit. No one likes adding additional medication but the benefits of getting that restful night’s sleep when all else fails is tough to put a price on.

In conclusion, while we continue to unravel the complexities of fibromyalgia, one thing is clear: improving sleep quality is a cornerstone in managing this condition, and probably many, many others in rheumatology. By adopting better sleep habits, we can significantly impact our journey towards a healthier, more comfortable life with fibromyalgia. Remember, each small step taken to enhance your sleep can lead to a significant leap in managing fibromyalgia symptoms. It’s not just about closing your eyes to the world; it’s about opening up to a better quality of life.