How is it possible for sufferers to wake up in the morning feeling more tired than when they went to bed the night before? Some sufferers do not realise that this problem is recognised as one of the major symptoms of Fibromyalgia.

Many people with FMS do not progress through the five stages of sleep. They may go to sleep easily, but wake up early in the morning (3 to 5am) unable to go back to sleep, or to go back into deep sleep. Others may have difficulty getting to sleep and then have interruptions during the night. 

Some even sleep through the night unaware of any difficulties, but may not be experiencing a deep restorative sleep. Other similar sleep scenarios are experienced by many people with Fibromyalgia.


Alpha-Delta Sleep Anomaly

This sleep disturbance in Fibromyalgia occurs in stage 4 of the sleep cycle. A disturbance in the brains’ electrical activity occurs, resulting in arousal, preventing the normal progression through the sleep cycle.

The sleep disturbance is referred to by researchers as the Alpha-Delta sleep anomaly, a condition in which brief periods of awake-like brainwaves (alpha waves) interfere with deep level (delta wave) sleep. It can be described as a state of partial wakefulness within sleep itself.

When this disruption occurs in stage 4 of the sleep cycle the body is not restored during sleep, this non restorative sleep is believed to be associated with the pain, fatigue and other symptoms of Fibromyalgia.

While the Alpha-Delta Sleep Anomaly is the most common sleep disorder found in Fibromyalgia patients, it is not the only one. John Russell MD. Studied 44 Fibromyalgia patient and discovered the following sleep disorders: Alpha- Delta sleep anomaly (43%), Sleep Apnea (25%), Sleep Myoclonus (16%)(involuntary arm and leg jerking during the night) and Teeth Grinding (14%).

The Link Between Serotonin, Sleep and FMS

Serotonin is a major neurotransmitter (a chemical that helps nerves transmit their messages) which is essential for the induction of deep level, slow wave sleep. An important component of the sleep disturbance in Fibromyalgia involves serotonin.

People with Fibromyalgia have been found to have low levels of serotonin in their blood and spinal fluid. At this time doctors are prescribing medications that increase the availability of serotonin in the body, with the ultimate goal being an improvement in the patient’s quality of sleep (more time in delta sleep) and reduced pain sensitivity.

More research must be done on the relationship between prescribed medications and the alpha-delta sleep anomaly. While these medications do influence the availability of serotonin the exact mechanism by which they operate is still not understood. There are still many questions to be answered.

How To Improve The Quality Of Your Sleep

  • Consult with your Doctor about the necessity of taking a medication to improve your sleep quality
  • If you are experiencing morning grogginess while taking a medication to improve sleep quality, take the medication as early as 6 pm
  • Allow time to wind down before bed
  • Follow a bedtime ritual (i.e. a warm bath, relaxing music, reading)
  • Eliminate caffeine after 12 noon
  • Reduce or eliminate fluid intake after 6pm. if you have a need to urinate during the night. Medications such as diuretics and blood pressure medications that get rid of excess fluid should be taken earlier in the day, whenever possible  (you will need to consult with your doctor first)
  • Use relaxation tapes
  • Develop a programme of gentle aerobic exercise, but avoid exercising in the evening
  • Actively deal with problems that interfere with sleep (e.g. pain and discomfort, crying baby, uncomfortable mattress or pillow, snoring spouse, concern about issues etc)
  • Seek treatment for depression, anxiety and/or stress if you are experiencing these
  • Avoid taking a nap late in the day as it may be more difficult for you to go to sleep at your normal time, or you may sleep for a few hours, then find yourself awake and be unable to get back to sleep
  • Don’t work in your bedroom
  • A glass of milk before bed may be helpful

To Sleep Or Not To Sleep?!

Establish a routine. Go through the same routine each night and have a consistent bedtime regime. Prepare for bedtime by reducing your activity level several hours before bedtime, and by having ‘going-to-bed’ rituals, that you do consistently at the same time every night.

Things like a warm drink, brushing your teeth, taking your meds, and maybe a bit of light reading every night can help you wind down and get ready psychologically for sleep.

  • Use your bed only as a place to sleep (Ahhem!.. erm there is one exception ! ) do not use your bed for other things….. such as eating, reading, paying bills or watching television. Avoid caffeine and alcohol within 6 hrs. of bedtime. Both can interfere with sleep.
  • Get up and go into another room to read or do something else relaxing when you cannot sleep. Tossing and turning all night keeps the muscles tensed and active. This may also contribute to you waking in pain and feeling tired.
  • When you begin to feel sleepy go to bed and try again, you may need to repeat this pattern several times during the night.
  • Try to get some regular exercise during the day or early evening, to help you feel physically tired. This will help you sleep better, but be sure to finish exercising several hours before bedtime.
  • Have a comfortable environment, try to provide yourself with a good mattress or mattress topper, and control light, noise and temperature (note: Noise, Ahhem….this includes snoring by your partner!).
  • Limit daytime napping, unless this doesn’t disturb your sleep at night, in which case you may need more rest.
  • Unwind and cleanse the mind, taking all your problems off to bed with you heightens anxiety and makes it difficult to relax, try writing down any issues and put them in a box, put the lid on and leave them till tomorrow.
  • Set up a sleep schedule, based on the number of hours sleep you need per night (no less than 7 hrs a night) incorporate your bed-time rituals, and what time you need to get up. It makes it easier to work out when you should start your bedtime regime.
  • Use relaxation or distraction techniques to fall asleep, such as concentrating on your breathing, peaceful calming background music.
  • Get up at the same time, setting an alarm so that you keep a routine by getting out of bed at the same time every day, can help you to adjust back to more normal hours