Insomnia, Restless Leg Syndrome, Sleep apnoea and non-restorative sleep are some of the common sleep disorders that occur as co-morbid conditions with fibromyalgia. As you can imagine, having issues with sleep does nothing to help the fatigue that already comes with being in chronic pain.
Insomnia is the inability to fall asleep. Such a simple definition which does not convey the frustration and helplessness that comes with it. Combine it with chronic pain and it is soul breaking.
Restless leg syndrome is characterised by an overwhelming urge to move the legs, particularly when trying to fall asleep. It has no known cause or treatment as yet. Thankfully, while I had started to develop signs of restless leg syndrome, for me it seemed to be associated with a deficiency in, or a higher requirement for magnesium, as it does not happen while I am taking magnesium supplementation. If you suffer from this, it’s probably worth trying magnesium supplementation. I am in no way saying it will cure it, I am just saying that it might help.
Sleep apnoea is a condition where you stop breathing during sleep. Suffers might be aware of it, as eventually the brain, in a desperate attempt not to die, will wake you up. But sometimes it doesn’t wake all the way up. The brain might only wake you just enough so that you breathe again. Either way it contributes to not sleeping properly. Treatment varies from splints to pull your jaw forward so you don’t block your own trachea, to CPAP machines that use positive pressure air to force your airways to stay open. As far as I know, I only suffer from this when I have a head cold.
For me, the main sleep problem I have is non-restorative sleep. I generally don’t have too much trouble falling asleep, but staying asleep and waking feeling rested seem to be beyond me.
I find if I nap during the day, I then am unable to fall asleep at night. So as much as I want to, on a regular day, I avoid naps.
The main treatment for non-restorative sleep is to improve sleep quality. I take a multi-faceted approach to this:
- Cutting down/out caffeine. I found I was needing more and more coffee/tea for it to help. The more caffeine I drank, the worse I would sleep, so I would have more caffeine and the cycle would continue. Cutting out the caffeine means that when I really need it – like for a function or particular type of headache, then it actually does something and I can have it early enough in the day that it doesn’t affect my sleep.
- A comfortable mattress and pillow. Get the best quality you can afford. We have a Zen mattress that has a latex top, it helps reduce pressure on painful joints. I previously used a foam pillow, but I’ve recently been trialling a buckwheat pillow. I get a thumping in my ear when I try to lie on my side, and I find that the buckwheat pillow lets me dig a little hole for my ear to sit over and that stops the thumping so I can relax.
- Use bolsters and cushions. Use as many as you need to improve comfort. Put a pillow between your knees if you are a side sleeper, or under them if you sleep on your back. I have issues with my shoulders, so I have a small cushion that I prop my hand up on when I lie on my side, and this relieves most of the pressure on my shoulder joint.
- Quality linen in natural fibres. I choose bamboo or cotton. It really does make a difference. Also change them regularly. This can be hard when you have a chronic illness, but it really is worth it overall.
- Comfortable bed-clothes. Gone are the cute little slip nighties that used to bunch up around my waist and leave my shoulders out to the cold. Now I have comfortable cotton or fleece PJ’s (depending on the time of year). The bonus to this, is I can answer the door when the courier delivers parcels at 7 am without a mad dash to cover myself up! In winter time, I wear socks and a beanie. I don’t care what others think, I just want to be warm.
- Appropriate bedding for the temperature. My darling knight needs the air-conditioning on pretty much from October to April. I however, get cold super easily. So we have separate single sized doonas. In summer, I have a light bamboo one (balances out the tarnished knight’s air-con), the knight uses just an empty doona case, and in winter I have a lovely wool one (and sometimes blankets as well) and the knight gets the bamboo one. It works beautifully for us, plus, there’s no fighting over the linen!
- Regular bed time. I try to make sure that I get to bed between 9 and 9:30pm. Any later than that and I know I’m adding to tomorrow’s toll. Sometimes it’s unavoidable, but if at all possible, I try to avoid evening functions. I usually wake up multiple times throughout the night and in the morning around 6 or 7 am, I generally can’t sleep any more – regardless of when I go to bed. So 9:30pm is the limit.
- Reducing blue light at night. I’m not very good at this one. I’m a bit addicted to technology. I do have blue light filters on all my devices, which reduces the damage of screens, but doesn’t completely stop them. I won’t allow a TV in the bedroom. If I wake in the night and can’t get back to sleep, then I am very strict about not using any devices. As tempting as it is to go online and see who else is out there suffering from insomnia, it is actually the worst thing you can do. Light inhibits production of melatonin in the pineal gland and melatonin is the hormone the regulates sleep.
- Which brings me to – melatonin. I take a drug called Circaden every night, which is a slow release formula of melatonin. Since taking this, I have noticed that when I wake up during the night, I usually manage to get back to sleep.
- In the morning, I try to get some sun on my face. This inhibits production of melatonin at the right time of day and helps the body to regulate many of the other hormones that are needed for homeostasis.
When I am good about my sleep routine, and nothing else goes wrong (storms, barking dogs, neighbourhood parties, etc.) then I usually get a reasonable level of sleep. I wake up with my pain at a manageable level and I can usually manage to get a few things done about the house.
If I get slack or have a function on, or something outside my control interferes with my sleep, then I tend to find that the FibroTroll is much more demanding. When this happens, I have to learn to give myself permission to rest. To not get anything productive done and simply pay the toll. If I don’t then the FibroTroll will invite his family over, and it won’t be pretty.
