Fibromyalgia and Sleep

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from depressive symptoms, should they exist at all.

There may also be an association between fibromyalgia and restless legs syndrome (RLS), a neurologic sensorimotor disorder characterized by an overwhelming urge to move the legs when they are at rest. RLS is more common among patients with fibromyalgia and those with rheumatoid arthritis than among people who don't have these conditions. An awareness of this association will help doctors look for and manage RLS symptoms among patients with fibromyalgia.

There are a variety of conditions that could lead to widespread pain and chronic fatigue. However, fibromyalgia typically also includes cognitive difficulties and psychological distress and a complaint of fatigue that is debilitating, unexplained, and unrelieved by rest. It is possible to experience symptoms similar to fibromyalgia if a person is suffering from sleep apnea. In addition, people with fibromyalgia may also suffer from sleep disorders such as sleep disordered breathing. Before seeking medical intervention for fibromyalgia, keeping a sleep diary as well as a sleepiness diary is recommended.

SYMPTOMS:

Fibromyalgia usually includes a broad range of symptoms including some combination of the following:

  • widespread pain
  • sleep disturbances
  • chronic daytime fatigue
  • morning stiffness in the joints and muscles
  • migraine headaches
  • irritable bowel syndrome
  • painful menstrual periods
  • numbness or tingling of the extremities
  • restless legs syndrome
  • temperature sensitivity
  • dizziness and balance problems
  • cognitive and memory problems
  • mood disturbance such as depression and anxiety

TREATMENT:

There are no FDA-approved drugs specifically developed for fibromyalgia but there are medications commonly used for other conditions that are effective treatments for fibromyalgia symptoms. In treating fibromyalgia, many physicians focus primarily on pharmacologic treatment, but self-directed and behavioral methods such as exercise and massage therapies have been shown to benefit patients as well. Also, improving sleep usually reduces pain and fatigue and improves daytime functioning.

No one treatment plan is uniformly effective for every fibromyalgia patient; those consisting of a combination of pharmacologic and nonpharmacologic therapies should be designed for each patient, and the clinician may have to try several different combinations before reaching improvement in the patient's symptoms. The important thing to keep in mind is that

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