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April 4, 2003
By Nicholas Rummell
Source: Missouri Arthritis Rehabilitation Research & Training Center (www.marrtc.org). Email contact: marrtc@health.missouri.edu. Reprinted with permission.
For adults with fibromyalgia, pills may or may not help resolve the sleep difficulties that challenge many. For starters, not everyone with fibromyalgia is helped by sleeping pills, prescription or over-the-counter.
And in some cases, a sleep medication may help a person fall asleep but then not help them achieve deep, restorative sleep. When it comes to sleep for adults with fibromyalgia, pain medications also may interfere with an adult’s ability to sleep.
Fibromyalgia is an illness that affects 3.7 million people, predominately women. The illness is characterized by chronic, widespread pain. Common symptoms include sleep disorders and fatigue, according to the Centers for Disease Control and Prevention.
SLEEPING PILLS
The prescription sleep medication Ambien ® can help induce sleep. Yet, in some cases, it does little to help maintain restorative sleep, said Anne Winkler, M.D., medical director of the Smith-Glynn-Callaway Medical building's fibromyalgia program in Springfield, Missouri.
Restorative sleep - also known as delta sleep -- is the most crucial stage of sleep. It is during this stage that the body recovers energy and repairs muscle tissue.
Without delta sleep, a person with fibromyalgia might sleep eight hours yet wake feeling unrefreshed.
Tips for Good Sleep:
1. No afternoon naps (At least limit naps to less than an hour).
2. Cut out caffeine, cigarettes and alcohol, especially four hours before bedtime.
3. Avoid late night snacks.
4. Eat well and maintain a balanced diet.
5. Maintain a steady sleep pattern. Don't go to sleep at 2 in the morning, only to hit the hay at 7 the next evening. This goes for waking up, too.
6. Exercise regularly, but not right before bedtime. Try to stay active, even if you are bored, tired or in pain.
Some prescription medications such as Amitriptyline are better options people with FMS because they provide long-term sleep aid, said Winkler.
Over-the-counter sleeping pills, such as Tylenol PM, do not induce deep sleep, and are counter-productive for people with FMS, according to The Oregon Fibromyalgia Network. (www.myalgia.com)
PAIN PILLS
For adults with fibromyalgia, taking pain pills can present a difficult choice between getting a good night's sleep and preventing agony. For example, the prescription pain medication Ultram (Ultram.com) relieves pain but it also can make someone taking the medication feel wide awake, said Winkler.
Along with the various effects of medications, every case of fibromyalgia is different, Winkler said. A medication that provides relief in one case might offer nothing in another. "The art of medicine is to find treatments that result in a happy medium," she said.
BEYOND PILLS
Sleeping soundly and deeply may seem like a dream to people with fibromyalgia but practicing good sleep hygiene can help.
First, avoid "power napping" or afternoon naps, said Michelle Merker, M.D., a sleep specialist at the St. Luke's Hospital sleep disorder center in Kansas City. Naps seem like they provide more sleep time, but are counterproductive to getting rest.
"Naps during the day affect how you will sleep during the night," she said. "It gets the body out of sync with the regular sleep pattern, and leads to insomnia at night."
Merker also advises people to check with their physician before using over-the-counter meds such as Tylenol PM. Researchers and physicians advise limiting stress and physical stimulants. That means no television in the bedroom or stacks of undone work.
© Missouri Arthritis Rehabilitation Research & Training Center. All rights reserved. Visit the MARRTC website: www.marrtc.org.
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