Fibromyalgia syndrome causes symptoms of extreme pain in the muscles throughout the body. Sometimes the pain associated with the illness can be so intense that sufferers cannot continue with their daily tasks. But fibromyalgia isn’t just associated with pain. Fibromyalgia and sleep disorders also go hand in hand. In fact, it is thought that up to 80% of people with fibromyalgia experience some type of disordered sleep. Often, these sleep disorders leave people feeling tired, drained, and physically incapable of dealing with the stresses associated with fibromyalgia.
Alpha EEG Anomaly
An alarming percentage of fibromyalgia sufferers have a sleep disorder called alpha EEG anomaly. This sleep disorder may actually be a
cause of fibromyalgia because so many sufferers have it. Alpha EEG anomaly affects deep sleep, preventing sufferers from getting a good night’s rest.
Alpha EEG anomaly occurs when sudden bursts of brain activity occur during a time when the brain should be in deep sleep. These periods of intense activity are measured as alpha waves on an EEG monitor. People with alpha EEG anomaly do not have difficulty falling asleep, but once they reach deep sleep, their brains begin to act like they are awake. This leaves sufferers feeling tired and drained.
Sleep Apnea
80% of people with fibromyalgia suffer from sleep apnea, a disorder that causes momentary stoppages in breathing. Sleep apnea only occurs when a person is sleeping, but it can affect some people so badly that they actually cause themselves to wake up. Many people who suffer from sleep apnea don’t even know that they have it - usually it is a partner that notices the sufferer waking up.
In apnea, there are gaps in breathing that can last for a few seconds or even as long as a minute. These gaps are often caused by a collapse in the airway due to snoring or being overweight. This is referred to as obstructive sleep apnea. However, there is also a much less common form of sleep apnea that appears to be caused by a defect in the central nervous system.
Referred to as central sleep apnea, this type of apnea is caused by a miscommunication from the brain. For some reason, the brain "forgets" to tell the lungs to breathe. People suffering from this type of apnea usually remember waking up.
Sleep apnea symptoms can affect a person’s sleep patterns. Some people with severe sleep apnea actually wake themselves up hundreds of times a night, if only for a few seconds. This prevents the body from benefiting from any restorative sleep. Sleep apnea can leave fibromyalgia sufferers feeling increasingly
fatigued and even more subject to pain.
Restless Leg Syndrome (RLS)
Many people with fibromyalgia suffer from restless leg syndrome symptoms. RLS causes unpleasant sensations in the lower limbs, so much so that the limbs have to be moved in order to reduce the pain. RLS occurs mostly at night, between the hours of 10:00 pm and 4:00 am, though it can also occur throughout the day in severe cases.
In a 2008 study, 64% of participants with FMS also had RLS.
RLS is exacerbated by long periods of rest, particularly nighttime sleeping, long car rides, or airplane travel. People with RLS describe crawling, itching, burning, or aching sensations beneath the skin in their legs. These sensations are so uncomfortable that they must move their legs, either by getting out of bed, or by exercising or
stretching. Many find that if they do not move around, their legs will twitch involuntarily. Typically, RLS affects the calves and lower legs, though it can also affect the thighs, feet, and arms.
RLS causes major disturbances to sleep patterns. Because you are constantly being woken up or forced out of bed, many FM sufferers find that they just cannot get adequate rest. Many feel drained and sleepy during the day.
RLS is a neurological condition, but we don't yet know what causes it. Some cases may have a genetic cause, while others are believed to be related to:
- Anemia
- Pregnancy (especially in the last trimester)
- Chronic diseases, including:
Diagnostic criteria for RLS include:
- A desire to move limbs, often linked to odd sensations
- Symptoms that are present (or worse) when you rest; movement provides some temporary relief
- Motor restlessness
- Worsening symptoms at night
Symptoms of Restless Legs Syndrome and Fibromyalgia
Fibromyalgia and RLS share these symptoms:
- Excessive daytime sleepiness
- Problems with concentration
The primary symptom of RLS is odd sensations (parethesias) or unpleasant sensations (dysesthesias) in the legs and an uncontrollable urge to move to relieve these sensations. This phenomenon is not associated with FMS and requires different treatment.
Restless Legs Syndrome Treatment
RLS treatments can include medications and lifestyle changes.
For mild-to-moderate symptoms, your doctor may suggest you cut down or eliminate use of caffeine, alcohol and tobacco. If you have nutritional deficiencies, especially iron, folate or magnesium, your doctor may suggest supplements.
Other lifestyle management techniques include:
- Maintaining a regular sleep schedule
- Regular, moderate exercise
- Avoiding excessive exercise
- Hot baths
- Leg massages
- Applying heat or ice
These measures, however, don't generally provide complete symptom relief.
Your doctor may suggest medication to treat RLS. The more common types include:
- Dopaminergics: (Examples are Requip, Mirapex) These drugs act like dopamine, which is a neurotransmitter that regulates muscle movement.
- Benzodiazepines: (Examples are Valium, Xanax) These are central nervous system depressants, generally used as anti-anxiety medicines, that also suppress muscle contractions.
- Opiates: (Examples are Darvon, Percodan) These pain killers also relax you and can suppress RLS in some people.
- Anticonvulsants: (Examples are Neurontin, Tegretol) These are normally for preventing seizures but sometimes help relieve muscle contractions.
Some medications may make RLS symptoms worse, including antinausea, anticonvulsant and antipsychotic drugs and some cold or allergy medicines. If you're taking any of these, you may want to talk with your doctor about changing to drugs that are less likely to worsen your symptoms.
Restless Legs Syndrome Treatment vs. Fibromyalgia Treatment
RLS treatments don't generally conflict with FMS treatments, and in many cases, treatment may help both conditions. Many people with FMS find relief from benzodiazepines, opiates or anticonvulsants. (While they're widely used, benzodiazapines and opiates aren't part of official recommendations for FMS.) Also, many RLS lifestyle management techniques (regular sleep schedule, moderate exercise, hot baths) can be useful in managing FMS symptoms.
If you're taking or considering medications for both fibromyalgia and restless legs syndrome, be sure to talk with your doctor and pharmacist about any possible drug interactions.
Periodic Limb Movement Disorder (PLMD)
Periodic limb movement disorder often occurs alongside RLS. In fact, 80% of those fibromyalgia sufferers who have RLS also have PLMD. PLMD is very similar to RLS, however it only occurs during nighttime sleep. It can also become quite exacerbated and even violent, unlike RLS.
PLMD causes intermittent movement of a person’s limbs while they are in deep sleep. A person with PLMD may move their feet, knees, or thighs rhythmically without even realizing it. Most movements occur at intervals of between 5 and 60 seconds. For example, a person with PLMD might suddenly flex their knee, and then 60 seconds later, flex it again. These flexes tend to last for 10 seconds or more. The most common movements seen in this sleep disorder are flexes of the big toe, fanning of the toes, and flexion of the knees.
PLMD can be quite annoying when you are already suffering from widespread
pain and other fibromyalgia symptoms. Sometimes people with PLMD can become quite violent, kicking and flailing while they are in bed. People with PLMD often report bouts of insomnia or daytime sleepiness, which can exacerbate their symptoms.
Bruxism
Bruxism (teeth grinding), frequently affects people with fibromyalgia. Bruxism is thought to be a part of a disease that is closely related to fibromyalgia, called
Temporomandibular Joint Disorder (TMJD). This disorder causes muscle pain in the face, neck, shoulders, and back, and often leads to grinding of the teeth. 75% of people with fibromyalgia also have TMJD.
Nocturnal bruxism occurs when you are sleeping. For some reason, sufferers begin to clench the muscles in their face causing their teeth to grind together. Many are unaware of this as they are sleeping, but in the morning they can be left feeling achy and sore in the jaw area. Bruxism can lead to a variety of dental problems, including loosened and broken teeth.
