Un-refreshing sleep in Fibromyalgia

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So, this was my FitBit reading for my sleep when I woke up after 9:30 this morning, 9:30!!!! It’s as if I slept half of the day away!!! This is so frustrating! Although I slept for 11 hours, of which 7.5 of that was deep sleep, I still woke up feeling like I could have slept 5 more hours, I am fatigued, and in a lot of pain. This is what is known as unrefreshing sleep in fibromyalgia sufferers. Let me tell you, it is not fun! I wake up feeling this way EVERY SINGLE DAY, however, today feels like a day where I need to mention it because even after sleeping for 11 hours, I still feel unrefreshed!!! SO incredibly frustrating. My mornings are ALWAYS slow going – I have to lay in bed for at least 30 minutes willing myself to get up, then once I’m up it’s a HUGE struggle to make my coffee, and then wake my brain and body up. It usually takes me about 3-4 hours to finally wake up. In comparison, Bart, who is pretty healthy, jumps out of bed at 6:30 in the morning after sleeping for 6-7 hours, jumps in the shower, and is raring to go, and does not need ANY coffee. Oh to wake up feeling like that just ONE day!!! It’s quite the daily struggle. Even after waiting for my body and mind to wake up for 3-4 hours, I truly don’t really get any energy / am feeling less fatigued at 7PM, the time where my body should be winding down for bed!!! So needless to say, it’s very difficult to get even the simplest things done throughout the day. I hope one day I figure out how to fix this major sleep / unrefreshing sleep issue.

Unrefreshing sleep has long been noted as a feature of fibromyalgia and it’s one that may be linked to many of our symptoms. One study reports that as many as 95 percent of people with fibromyalgia report unrefreshing sleep.

A growing body of research is leading to a better understanding of unrefreshing sleep in this condition, its features, its effect on us, and how it may be alleviated.

What is Unrefreshing Sleep?

Unrefreshing sleep, also called nonrestorative sleep, is not the same thing as insomnia (which can also be present in fibromyalgia).

It’s not tied to how hard it is to get to sleep or to how long you sleep.

Instead, unrefreshing sleep is more about the quality of your sleep. It’s light, and even after sleeping for a full night, you wake up feeling exhausted and as if you’ve hardly slept. However, the impact of unrefreshing sleep can go well beyond feeling tired.

While unrefreshing sleep and other sleep-related problems are considered a symptom of fibromyalgia, research shows that they’re tied to abnormalities in brain chemistry and the immune system in a complex way and, according to a 2012 study, may serve as “both a cause and a consequence of fibromyalgia.”

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Impact of Unrefreshing Sleep

Research links this poor-quality sleep to multiple symptoms of fibromyalgia, including:

  • Increased tenderness
  • Lack of overnight recovery from pain
  • No morning feelings of well-being
  • Cognitive impairment (fibro fog)
  • Poor performance of tasks
  • Morning achiness
  • Stiffness
  • Fatigue
  • Psychological distress

Why is Sleep Unrefreshing in Fibromyalgia?

So far, it’s not well understood why sleep is generally unrefreshing in people with this condition.

The most obvious explanation is that it’s hard to sleep when you’re in pain, and many people with fibromyalgia report significant pain from simply lying down on their tender muscles.

The tendencies to get chilled and overheated and sweat excessively may also contribute to sleep problems.

Research shows that dysfunction in the autonomic nervous system (ANS) may play a key role, as well.

The ANS is separated into two parts — the sympathetic (fight-or-flight mode) and parasympathetic (rest-and-digest mode.) According to an emerging theory of fibromyalgia, the sympathetic nervous system appears to be stuck “on,” preventing the body from truly relaxing and being able to sleep.

This state is similar to “sleeping with one eye open,” such as new parents do when they’re alert to a baby’s every cry, or like you might experience when you’re especially worried about oversleeping and therefore wake up and check the clock over and over.

A 2009 study (Prados) suggests that heart-rate variability, which is a measure of autonomic function, was abnormal during sleep in participants with fibromyalgia. This supports the theory of increased sympathetic activity that disrupts sleep.

Because pain disrupts sleep and poor sleep leads to pain, it can become a self-perpetuating cycle.

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Treating Unrefreshing Sleep

Research suggests that several medications may be able to improve sleep quality in fibromyalgia.

Some people with fibromyalgia report success with other prescription or over-the-counter sleep aids as well.

Research suggests that melatonin supplementation may improve sleep and pain in fibromyalgia.

I have been taking cyclobenzaprine 10mg nightly for the last 20 years, and it’s what has worked for me. Yes it turns me into a zombie, but without it, I toss and turn the ENTIRE night. I have tried 20mg of melanin (the max dose) but it doesn’t seem to work on me. I hope to one day get to the root of this issue!

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On a positive note – on days like today where I’m feeling more down than usual, I try to focus on the positives in my life, because there are MANY people and things to be grateful for.

Enjoy your Monday everyone! Once I am a bit more awake I am going to attempt to finish a case study I started writing yesterday, then take the dog to the park, then get ready for my night class tonight. Wish me luck!

Xoxo Lex

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3 thoughts on “Un-refreshing sleep in Fibromyalgia

  1. Hi Lex, this is right on in my experience! I got an activity tracker a few months ago and have learned a ton about my sleep patterns. Mine looks a lot like yours. Instead of the longer cycles they say are ideal, my sleep cycles go back and forth more rapidly and I have a lot of light sleep. My mornings are really tough. Just like what you describe. I wake up at 630 and get out of bed at 8. I go to work at 9, a full hour after just about everyone else, but no one complains. It helps me. I feel sore and stiff and not rested. Gabapentin has really helped me sleep through the night. Before that, I would wake up from pain before dawn and toss and turn. Nice post, seems very accurate to me! Hope you find ways to get better rest!!

    Like

    • Awww I’m so sorry to hear you experience the same thing, but it’s nice to know you understand where I’m coming from. I hope you’re not in too much pain when you’re at work. If I find something that does help, I will let you know!!

      Liked by 1 person

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