Fibromyalgia Fatigue

In addition to the pain of fibromyalgia, up to 90% of people with fibromyalgia suffer from chronic fatigue of moderate to severe intensity. The fatigue of fibromyalgia is not the fatigue that many people experience when they don’t get enough rest- the fatigue experienced by fibromyalgia sufferers is overwhelming, can last for weeks or months, and may severely impact the ability to lead a normal life. Fibromyalgia can be a vicious cycle, with pain leading to lack of sleep, and lack of sleep exacerbating the experience of pain.

Sleep disorders common to fibromyalgia

Although pain is one explanation for why people with fibromyalgia experience fatigue, research has pointed to various sleep disorders as a possible explanation for the intense fatigue that is almost universally experienced by fibromyalgia sufferers.

Some of the sleep disorders that have been found to plague those with fibromyalgia include:

Restless leg syndrome (RLS)
RLS is characterized by an intense desire to move the legs or the body to interrupt intense and uncomfortable sensations. These sensations are often described as burning, tingling or tickling sensations; the sensations are relieved by movement. Symptoms of RLS are often worse at night, when the body is at rest, and can significantly disturb sleep.
Sleep apnea
Sleep apnea is characterized by frequent periods of apnea, or the cessation of breathing, resulting in frequent awakenings during sleep. The person with apnea may be unaware that they have a problem and may only complain of excessive daytime drowsiness. Others around them may notice symptoms and alert the person. Sleep apnea can be diagnosed through a sleep study, in which breathing and oxygen levels are monitored while the patient is asleep.
Alpha-EEG anomaly
This disorder results in repeated, sudden bursts of brain activity during sleep, interrupting deep sleep, the phase of sleep in which restoration takes place. People with this disorder may suffer from chronic fatigue due to frequent awakenings.

Lower chemical levels

In addition to sleep disorders, people with fibromyalgia often have below-normal levels of certain brain chemicals that are essential for proper sleep patterns and a sense of mental well- being:

Serotonin
Serotonin is a neurotransmitter that helps to regulate many bodily functions, including sleep. Serotonin works in conjunction with melatonin to help you to fall asleep and to wake up feeling rested. It is thought that people with fibromyalgia have low levels of serotonin, which may partially explain fatigue. In addition, their brains may be unable to properly utilize serotonin, even when serotonin levels are adequate.
Norepinephrine
Norepinephrine is a neurotransmitter involved in the fight-or-flight response. People with low levels of norepinephrine may experience memory problems, lack of interest or depression. There is some evidence that people with fibromyalgia have low levels of this important chemical, and that this may exacerbate fatigue.
Dopamine
Low levels of dopamine are thought to contribute to “fibro fog”, the cognitive symptoms that many people with fibromyalgia experience. Confusion, trouble concentrating and difficulty with short-term memory and focusing on tasks may be experienced. These symptoms may be made worse by lack of sleep.

Fatigue may be overwhelming, leading to an inability to perform normal everyday functions. Fatigue may also contribute to depression and anxiety and worsen pain symptoms. Medications may help, particularly drugs that target neurotransmitter activity. Some people with fibromyalgia find that drug therapy is effective, while other choose to use non-pharmacologic approaches to improving sleep patterns. Whatever the approach chosen, gaining control over sleep can improve pain and functioning and lead to improved coping and a greater enjoyment of life.

 

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Fibromyalgia is a prevalent condition that affects many people in the United States. Approximately 3.7 million Americans have Fibromyalgia. That is 1 in every 73 people.

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