Fibromyalgia and Chronic Fatigue Syndrome (CFS) are both extremely common conditions with different diagnostic criteria, but have so many similarities that one is often associated to the other. CFS is an illness characterized by profound disabling fatigue lasting at least six months. It is medically unexplained and accompanied by symptoms of poor sleep quality, musculoskeletal pain, and impaired physical and mental functioning.
Symptoms
Fibromyalgia is a syndrome characterized by chronic fatigue and widespread muscular pain in the muscles and fibrous connective tissues. Its cause is unknown. It involves soft tissue pain rather than joint pain arthritis, and as such it is considered a rheumatoid condition, not a true inflammatory disease. Pain usually occurs throughout the body, but may start in one region and spread over time. You may feel like you have a permanent flu with aches and sores or experience a burning sensation. Your pain may be extreme when pressing on specific tender points. The intensity of your symptoms may change according to the time of the day, the weather, your activity level, sleep patterns, and level of stress. Sleep deprivation makes symptoms worse and pain makes sleep more difficult.
Symptoms of fibromyalgia allied to sleep deprivation can be very debilitating. To restore healthy sleep and alleviate your symptoms, consult your medical provider or a qualified and sleep specialist, especially if your symptoms are deteriorated by sleep deprivation and sleep problems are exacerbated by pain.
If you experience the following symptoms, consult your health care provider or a qualified sleep disorders specialist.
- stiffness in the muscles and joints
- sleep disturbances
- chronic daytime fatigue
- migraine headaches
- irritable bowel syndrome
- abnominal cramps or pelvic pain
- diarrhea
- numbness or tingling of the extremities
- restless leg syndrome
- hypersensitivity to heat or cold
- dizziness and balance problems
- cognitive and memory problems
- anxiety and depression
Characteristics
Fibromyalgia affects over 2 to 4% of the American population, primarily middle-aged women in over 80% of cases diagnosed. FM onset frequently occurs during the twenties or thirties, may run in families and lies dormant until triggered by an infection, injury, stress, or sleep disturbance. Discomfort can be so severe that it may significantly limit your ability to work and perform everyday tasks, such as driving, grocery shopping or house cleaning. The non-restorative sleep and accumulated fatigue may cause to be depressed and deeply affect your ability to concentrate and impair your mental faculty.
Diagnosis
You should keep a sleep diary and a sleepiness diary before meeting with your physician. Diagnosis of fibromyalgia is based on a careful review of your medical history, the presence of abnormal deep sleep characteristics, and widespread musculoskeletal pain for over three months and localization of at least 11 out of 18 tender points in specific parts of your body such as the neck, chest, shoulders, hips and knees. Your physician may also rule out other potential sleep disorders or somatic, anxiety, and affective disorders.
Treatment
No definite cure has been found, but you can learn to manage your symptoms by combining pharmacologic and behavioral treatments. Careful treatment monitoring and adjustment may be necessary as each patient reacts differently.
Behavior therapy
- Establish good sleep hygiene
- Decrease caffeinated drink and alcohol, and avoid smoking
- Keep a regular sleep schedule with adequate amount of sleep and maintain regular sleep/wake times
- Sleep only when sleepy and only as much as needed
- Exercise daily mid-afternoon and early evening. Walking, gentle aerobics, water exercise and stretching are recommended since it promotes subsequent nighttime production of growth hormone, relieve symptoms and prevent deconditioning.
- Practice yoga, relaxation and stretching, preferably later in the day
- Avoid overexertion and stress
- Participate in a support group.
Medication
A variety of drugs help relieve symptoms. However, improvement varies from person to person as side effects may apply and limit drug use.
- Antidepressants. Amitriptyline (Elavil), doxepin (Sinequan), cyclobenzaprine (Flexeril), duloxetine hydrochloride (Cymbalta) are used as muscle relaxant to help diminish pain and enhance sleep.
- Epilepsy medications. Pregabalin (Lyrica) is designed to reduce pain and improve functioning.
For More Information
For more information about fibromyalgia, visit the American Academy of Sleep Medicine at http://www.sleepeducation.com, the National Sleep Foundation at http://www.sleepfoundation.org/article/sleep-related-problems/fibromyalgia-and-sleep and the National Fibromyalgia Association at www.fmaware.org
