Non-Restorative Sleep In Fibromyalgia

Published: // Updated: March 14, 2021

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Do you wake up feeling exhausted even after sleeping all night and feel as if you have hardly slept at all?  It’s poor quality sleep. Non-restorative sleep (NRS), also called unrefreshing sleep, is the number one sleep disorder in people with fibromyalgia.  

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 It is estimated that 80% of people with fibromyalgia have NRS. Brainwave studies have found that fibromyalgia patients lack restorative levels of deep sleep.   

People with fibromyalgia show less deep (delta) sleep, increased lighter stages (alpha) of sleep, and wake up frequently during the night. The lack of restorative (delta) sleep is why you might sleep 8 hours, yet wake feeling unrefreshed.

The impact of non-restorative sleep can go well beyond feeling tired. Research links this poor-quality sleep to multiple symptoms of fibromyalgia, including:

  • Increased tenderness
  • Lack of overnight recovery from pain
  • Cognitive impairment (fibro fog)
  • Poor performance of tasks
  • Morning achiness and stiffness
  • Fatigue
  • Psychological distress

The 4 Stages of Sleep

Previously, experts divided sleep into five different stages. Stages 3 and 4 were combined so now there are four stages of sleep.

There are 4 stages of sleep in the course of a normal nights rest:

  • Stage 1 is the beginning of the sleep cycle. It is light sleep where you drift in and out of sleep and can be awakened easily. In this stage, the eyes move slowly and muscle activity slows. This period of sleep lasts only a brief time (around 5-10 minutes).
  • Stage 2 is the second stage of sleep and lasts for approximately 20 minutes. Eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves.
  • Stage 3 is referred to as deep sleep or delta sleep. It is during these deepest levels of sleep that the body restores and refreshes itself.
  • REM (Rapid Eye Movement) is when dreaming occurs. REM sleep is characterized by eye movement, increased respiration rate, and increased brain activity.

Sleep begins in stage 1 and progresses into stages 2 and 3. After stage 3 sleep, stage 2 sleep is repeated before entering REM sleep. Once REM sleep is over, the body usually returns to stage 2 sleep.

Sleep cycles through these stages approximately four or five times throughout the night. A complete sleep cycle takes an average of 90 minutes.

The first sleep cycles each night have relatively short REM sleeps and long periods of deep sleep but later in the night, REM periods lengthen and deep sleep time decreases.

How Does Non-restorative Sleep Relate To Fibromyalgia

Many fibromyalgia sufferers either don’t reach deep sleep, or they don’t stay there for long. Instead, alpha waves return, indicating that part of the brain is improperly active at that time.

Research suggests that people with fibromyalgia are constantly aroused by bursts of brain activity that limits the amount of time spent in deep-stage restorative sleep.

One theory as to why is that brain chemicals are out of whack. There is evidence that fibromyalgia is associated with abnormal levels of neurotransmitters (dopamine, serotonin and substance P) and hormonal imbalances (growth hormone, cortisol).

In addition to interfering with restful sleep, neurochemicals and hormonal imbalances may increase the pain associated with fibromyalgia.

So, in order to live with less pain, we must improve the quality of our sleep, You might want to read these 4 tips to improve your sleep.

Does Fibromyalgia Cause NRS Or Does NRS Cause Fibromyalgia?

A recent study in Norway suggests that non-restorative sleep could cause women to develop fibromyalgia. This article, Fibromyalgia Risk Greater Among Females With Poor Sleeping Habits at Medical News Today gives more information about the study.

Trouble sleeping came long before I developed any other symptoms of fibromyalgia. What about you? What came first, poor sleep or fibromyalgia?

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6 thoughts on “Non-Restorative Sleep In Fibromyalgia”

  1. My sleep issues arose from pain issues. I cannot “sleep” for more than a couple of hours without excruciating pain. I move from bed to sofa several times through the night. Sometimes, the only place I can really rest is in the bathtub. Then, when the water gets cold, it causes my pain to be worse. If I had a bathtub water heater, to keep rewarming the water, I would j u st live in the tub, and have pruned fingers and toes all the time.

    Reply
  2. They say the 3rd time is the charm…

    Recap: (not sure if my first two attempts to post before finishing will turn up as well) turning 47, Fibro since 90’s, sleep apnea diagnosed later, increased symptoms and intensity of pain levels and sensory touch.

    All that time I never looked back to early childhood or adolescent stage to try and find a correlation. EVEN when knowing that pain keeps you from restorative sleep which in turn causes more pain….

    Finally my brain kicked in and I thought of something that could be EXTREMELY relevant to my current disability state where I stay at home unless I have a doctor appt ect…  My Mom used to say I could sleep anywhere at anytime. I would take at least 2 naps as a child and still go to bed without any fuss. I hope this part does not offend anyone but I ALWAYS loved Christmas yet never once did I wake my parents up on Christmas morning. They had to practically drag me out of bed. And finally (although I’m sure there are many other signs I haven’t thought of yet), I’ve never understood when people would say they were looking forward to their day off so they could sleep in only to say later that they woke up at the same time and just couldn’t go back to sleep. What do you mean you can’t go back to sleep, just close your eyes?!?! I have NEVER in my life woke up completely refreshed, rejuvenated and full of energy…N-E-V-E-R

    Unfortunately the option for making your body go into REM sleep is limited to one, highly controlled, medication that is only approved for patients with narcolepsy. It’s called Xyrem and the reason for the strict monitoring is because the  active  ingredient of Xyrem is  a  form of  gamma-hydroxybutyrate  (GHB). Or what some may have heard being referred to as a “roofie”.

    So if there is anything out there that can force your body into REM (restorative) sleep, I would appreciate any info or direction you may know of. Even if there was a trial to see if REM sleep would decrease the severity of my symptoms, greatly reduce the level and number of medications I take and get me to where I can go back to work I would be eternally grateful. Being 47, on a limited fixed income and not being able to enjoy anything in life is a huge struggle everyday. But I won’t give up!!

    Reply
    • Hi, Catherine. My sleep issues also began in childhood. I had so much trouble falling asleep that I didn’t want to get out of bed either. I take amitriptyline to help me sleep. It works very well for me and most of the time I wake refreshed. Besides waking refreshed, I also dream which occurs during REM sleep. As long as I am getting restorative sleep I can deal with the pain and other symptoms of fibro. If I cannot sleep I can’t deal with anything. Not everyone has good results with amitriptyline but it has been a lifesaver for me. It is also very inexpensive. With my insurance plan, it costs $2 and I believe you can get it on many $4 prescription programs. Take care and gentle hugs.

      Reply

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