If there is one symptom that fibromyalgia patients describe as particularly debilitating, besides pain, it is sleep disturbance. It is not just simple insomnia: it is a sleep that does not restore, fragmented, superficial, after which one wakes up more tired than when one went to bed.
Sleep in Fibromyalgia
Research has shown that in fibromyalgia there is an alteration of the deep sleep phases. The brain waves typical of restorative sleep (delta waves) are disturbed by intrusions of alpha waves, normally associated with wakefulness. The result is a sleep that appears normal in duration but does not perform its restorative functions.
Why Is Sleep So Disturbed?
The nervous system of those suffering from fibromyalgia is in a state of hyperactivation constant. The sympathetic nervous system — the one that prepares us for action, flight, defense — remains active even when it should give way to the parasympathetic system, which presides over relaxation and recovery.
This imbalance has direct consequences on sleep:
- Difficulty falling asleep due to the inability to "turn off" the mind
- Frequent awakenings during the night
- Early awakening in the morning
- Feeling of non-restorative sleep
The Vicious Cycle of Sleep and Pain
Disturbed sleep and pain feed off each other. Poor quality sleep lowers the pain threshold, making one more sensitive to painful stimuli the next day. Pain, in turn, makes it harder to fall asleep and maintain deep sleep. Breaking this vicious cycle is one of the primary goals in managing fibromyalgia.
Serotonin: The Missing Link
Serotonin is a crucial neurotransmitter for both sleep regulation and pain modulation. In fibromyalgia, there is often a reduced availability of serotonin, which simultaneously contributes to sleep disturbances, lowered pain threshold, and mood alterations.
Strategies to Improve Sleep
Recovering quality sleep involves several measures:
- Sleep Hygiene: regular hours, a cool and dark environment, no screens before sleeping
- Reduction of Evening Stimuli: lowering lights and noises in the hours leading up to sleep
- Diaphragmatic Breathing: activates the parasympathetic system promoting relaxation
- Targeted Supplementation: magnesium and other nutrients that promote neuromuscular relaxation
- Gentle Movement During the Day: promotes evening physiological fatigue
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