FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME

Chronic Pain | Chronic Fatigue | Depression | Anxiety
Sleep Dysfunction | Vitamin and Mineral Deficiency

Sleep Dysfunction

 Normal Sleep Stages

During sleep, the body cycles between non-REM sleep and REM sleep.  Typically  people begin the sleep cycle with a period of non-REM sleep followed by a very short period of REM sleep.

It is during the deep stages on non-REM sleep that the body repairs and regenerates tissues, builds bone and muscle, and appears to strengthen the immune system.

Sleep Dysfunction

Up to ninety percent of patients with fibromyalgia complain of not feeling refreshed and rested after a night's "sleep". Often they awaken every one to two hours or they may toss and turn, unable to turn off their mind. Some are not able to fall asleep and others are not able to fall back asleep when they awaken. A majority of patients will say that they sleep "lightly" others claim to sleep "soundly" but in both cases they are not refreshed in the morning.

All sleep dysfunctions contribute to more pain and the most common ones are:

1. Alpha-Delta Sleep Anomalies:

The fourth stage of NON-REM sleep (delta sleep) is one of the deepest stages of sleep and is necessary for regeneration of hormones and neurotransmitters (i.e. growth hormone and serotonin).  In alpha-delta sleep dysfunction the time spent in deep, restorative sleep (delta sleep) is shortened and the person switches to a light sleep (alpha sleep) resulting in lower levels of growth hormone and serotonin.  Lower levels of growth hormone and serotonin then contribute to depression, fatigue, impaired ability to heal, lowered the immune system, and a general state of fatigue.

2. Sleep Apnea:

About 40% of fibromyalgia patients have sleep apnea which is associated with daytime fatigue and snoring.

3. Upper Airway Resistance Syndrome

Abnormal increased airway resistance leads to sleep arousal, secondary to increased work of breathing to overcome resistance. People who have this condition have snoring and daytime somnolence. Some may develop elevated blood pressure, fatigue, cognitive impairment, non-restorative sleep, frequent awakenings, and chronic pain.

Snoring - increased airflow which created vibrations of the pharyngeal structures
Sleep Apnea - a severe increase which obstructs the airway and stops the air flow which results in daytime sleepiness and desaturation (decrease of oxygen in the blood, possibly leading to heart rhythm abnormalities, strokes, heart attacks, and hypertension)

4. Periodic Limb Movement

 

5. Restless Leg Syndrome

 

Consequences of Sleep Dysfunction

The consequences of sleep dysfunction can be divided into two categories:

Behavioral and mood: sleepiness, psycho-motor impairment, accidents,
decreased work productivity, decreased quality of life, deficiency in learning and
memory, mood effects, lack of awareness, and stimulant-seeking behavior.

Physiological: hypoxemia (decreased oxygen), insulin resistance, metabolic
syndrome, sympathetic activity, blunted arousal response, increased pain
sensitivity, and decreased antibody production.

Impaired Memory and Thought Processes

Bain fog and other thought and memory symptoms can be caused by mitochondrial dysfunction and lowered blood flow to the brain, which are both worsened by lack of restorative sleep.

Depression

Sleep dysfunction reduces the production of mood stabilizing hormones such as serotonin and other neurotransmitters.  Therefore as restorative sleep decreases. depression and pain increase.

Decreased Immune System and Altered Temperature Regulation

Sleep deprivation suppresses immune system function.  Without restorative sleep the body's ability to fight infections is diminished, including the body's ability to fight infections with fevers, as well as T3 levels (causing hypothyroidism) and temperature.

Symptoms can include chronic sinusitis, bowel infections, chlamydia, mycoplasma, and viral infections.

Weight Gain

Without restorative sleep the body does not produce leptin.  Leptin helps the body to reduce food intake by controlling the sensation of hunger.