Although sleep disturbance is an obvious consequence/symptom of fibromyalgia, some researchers believe that non-restorative sleep (NRS) may actually cause and/or contribute to fibromyalgia-related pain (Moldofsky 2010). This bi-directional relationship is further supported by studies of fibromyalgia patients showing that improvement in sleep quality is linked to significant reductions in fibromyalgia symptom intensity (Prados 2012). Since serotonin is involved in pain signaling and sleep regulation, some researchers have suggested that abnormally low serotonin levels (commonamong fibromyalgia patients) may be one possible explanation for this connection (Arnold 2010). Clinical studies have also found that fibromyalgia patients may have low circulating levels of melatonin, which can lead to disruptions in sleep cycles (Hussain 2011). Among these patients, melatonin supplementation has been shown to improve sleep and fatigue-related symptoms (Reiter 2007).
As with pain, fibromyalgia-related sleep dysfunction should be managed in a step-wise fashion, starting with the least risky treatment. For many of those with fibromyalgia, improving sleep hygiene is enough to make a significant difference (Spaeth 2011). The sleep environment should be dark, cool, and quiet, and external distractions should be minimized. The sleep cycle should be normal (e.g., consistent bedtime and morning awakening time), and healthy lifestyle considerations (e.g., adequate exercise, smoking cessation, and avoiding nighttime alcohol use) may also help improve sleep quality (Leger 2010).
Patients who continue to have problems sleeping may require pharmacotherapy with agents such as zolpidem (Ambien®) and eszopiclone (Lunesta®). However, these medications can be habit forming and are not associated with subsequent pain relief (Spaeth 2011). On the other hand, natural supplements such as 5-HTP and melatonin are not only associated with improvements in sleep quality and pain score, but are also less likely to produce negative side effects (Reiter 2007; Sarac 2006).
I sleep much better than I did when I was taking medication. About an hour before bed, I stretch and practice MELT on my hands, feet and spine. I sometimes have a warm milk concoction I make from time time to time and I often have a calming tea at night.
I take magnesium, omega-3s, 5-HTP and some whole food vitamins before bed and use lavender oil. If it’s been a very stressful day and I feel agitation I will include ylang ylang oil and or frankincense oil. Finally, I have a breathing and relaxing meditation sequence I go through as I’m falling asleep. I rarely wake up before morning now.
Have you tried prescription medications to treat your insomnia or have you gone with more natural supplements and methods? Share your experience and insights in the comments below and help others Live Well with Fibro.