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Fibromyalgia And Sleep Disorder
        
   
Fibromyalgia syndrome (FMS) and sleep disorders may be viewed as a vicious cycle: persons with FMS often experience severe pain, fatigue, and cognitive dysfunction, all of which contribute to sleep disturbances that, in turn, result in intensified FMS symptoms that, in turn, further interfere with sleep, and so on. Noting that more than 90% of an estimated 10 million Americans with FMS report having disrupted and disturbed sleep, the National Fibromyalgia Association (NFA) has responded by launching an awareness campaign designed to improve the qualiiy of sleep in patients who have this condition. More specific goals of the campaign, called "Sweet Dreams," include increasing patients' and physicians’ knowledge of FMS-related sleep issues, particularly the debilitating effects of nonrestorative sleep. The campaign also encourages patients to practice good sleep hygiene in an attempt to improve sleep and ease FMS symptoms for better daytime functioning. "Sleep solutions" offered in the campaign include the following:
  • Information about the relationship of FMS and sleep issues, including a special section devoted to sleep and FMS in a recent issue of Fibromyalgia AWARE, an NFA publication.
  • To help patients become more active participants in solving sleep issues, an online pledge: "I pledge to join the FMS report having NFA in practicing good sleep hygiene and will do my part to raise awareness about the importance of sleep for people with FMS. I understand that I can help improve the quality of my sleep by making just a few simple changes."
  • Merchandise, including posters on sleep hygiene tips, pillows, fleece blankets, teddy bears, ceramic mugs and tea, earplugs, and relaxation CDs.
The NFA has advocated increased research on the inability of patients with FMS to reach deep sleep levels (stage 4) that are critical to muscle healing. In its brochure "Sleep Tips for People With Fibromyalgia," the NFA outlines some key points to increase patients' awareness and to help them make informed decisions:
  • Nonrestorative sleep, insufficient amounts of slow-wave and rapid eye movement (REM)-stage sleep, and other sleep difficulties can intensify pain in persons with FMS, contribute to memory and cognition problems, and increase mood disorders. Consulting with your physician can help you determine the specific problem and appropriate treatment.
  • Sleep medications might include low-dose tricyclic antidepressants and benzodiazepine like medications. New medications and other treatment approaches are being investigated.
  • Five stages of sleep are needed to awaken refreshed and energized: (1) a period of dozing, which provides a transition into light sleep; (2) non-KEM sleep nearly half of it); (3 and 4] slow-wave sleep—the stages of deep non-REM sleep characterized by delta brain waves—when the immune system is recharged, blood pressure is at its lowest, and the pulse is at its slowest; and (5) REM sleep—when dream-ing occurs and pulse, blood pressure, and breathing become irregular. Because many persons with FMS have alpha waves mixed with delta waves, their non-REM sleep is disrupted and nonrestorative.
  • A period of 7 to 9 hours of uninterrupted sleep per night is recommended. Persons with FMS can help themselves achieve this in a variety of ways (see the Box, "Better than counting sheep," below).
For more information on the "Sweet Dreams" campaign or other NFA resources, visit the NFA Web site at
www.FMAware.org. Or, contact the organization at National Fibromyalgia Association, 2200 N Glassell St, Suite A, Orange, CA 92865; telephone: (714) 921-0150; fax:(714)921-6920.

Better than counting sheep In its efforts to help persons with fibromyalgia syn-minimize sleep disorders and disturbances, anal Fibromyalgia Association offers the following recommendations:
  • Discuss sleep difficulties with your physician.
  • Arrange your bidding surface to maximize comfort, especially if pains keeps you awake
  • Maintain a consistent Sleep routine: go to bed and arise at the same times every day.
  • Avoid excessive light exposure in the evenings and do not turn lights on if you need to get out of bed during the night.
  • Exercise—in the morning or early afternoon. In preparing for sleep, take a warm bath to help you relax and cool down afterwards.
  • "Avoid caffeine, alcoholic beverages, and other alcoholic drinks, especially in the hours before bedtime.
  • Eat small amounts of cheese or nuts high in calcium and protein to promote sleep.
  • . Avoid allowing pets on your bed, because they Often move around during the night and create disturbances that wake you up.
  • To fall back asleep when you get out of bed during the night, climb back in and assume the same position you were lying in.
  • To maintain tranquility in your bedroom, avoid bringing in a computer and having intense discussions in bed.
  • If you experience difficulty in falling asleep, get out of bed, keep the room dark, and avoid activity that will stimulate your mind.
  • Avoid naps or limit them to less than 30 minutes to minimize difficulty in falling asleep at night.
 You can find more information about Fibromyalgia by clicking the link below:
http://www.rheumatology.org/public/factsheets/fibromya_new.asp?aud=pat
References:
Journal of Musculoskeletal medicine feb 2007, National Fibromyalgia Association, 2200 N Glassell St, Suite A, Orange, CA 92865; telephone: (714) 921-0150; fax:(714)921-6920, www.FMAware.org.