Poor Sleep is Frequently at the Root of Fibromyalgia

For decades, doctors have been challenged in treating patients with a condition known as fibromyalgia. Patients with fibromyalgia complain of pain in various parts of their body, and evaluation by the doctor does not identify any physical cause. There are no inflammation or arthritic changes in the bones to explain the daily difficulties with pain. More than 12 million Americans have been labeled with this diagnosis and treatment options have been limited; for the most part it has consisted of pain medications or medications that dull the nerve pain transmission from around the body to the brain. These medications frequently cause side effects including drowsiness, and their benefits lessen over time.

A new direction in the management of fibromyalgia stems from our growing knowledge of this mysterious disorder. Dr. Jerald H. Simmons, neurologist and founding director of Comprehensive Sleep Medicine Associates (CSMA), says that fibromyalgia is a condition in which the brain's pain-filtering system is fatigued and does not function correctly: "Our brains constantly filter out signals coming in from the nerve fibers throughout the body. This allows us to function without feeling every little impulse coming from all of the nerves. When we sleep, this filter in our brain restores itself in preparation to function throughout the next day. When we are sleep-deprived or have not gotten proper sleep, the filter system begins to malfunction and signals from the nerves that should have been filtered out instead get into the brain and create the sensation of pain."

Another way to describe this is that our pain threshold is lowered by poor sleep, and this relationship between sleep and pain has become increasingly dear. As it turns out, many patients with sleep disorders who have also been identified as suffering from fibromyalgia experience resolution of their fibromyalgia pain as a result of treatment of their sleep disorder. The link between sleep and other conditions has become increasingly clear. "If we improve sleep in fibromyalgia patients, we have seen that the pain improves as well," Dr. Simmons says. "Common sleep disturbances such as obstructive sleep apnea, restless legs syndrome or upper airway resistance syndrome seem to be underlying causes of patients' fragmented sleep. Many of these patients also complain of chronic fatigue syndrome, further implicating sleep disruption as a contributing factor. I have had excellent results from identifying the root of the disrupted sleep and then treating the sleep disturbance."

Dr. Simmons uses a new approach to treat patients with fibromyalgia that have not been identified as having another sleep disorder; it involves Zyrem, a medication originally used for treating narcolepsy. "Now that I'm on Zyrem, I feel better than I have in 20 years," said Nancy Schweining, one of Dr. Simmons' patients. "My pain is gone and I feel like I have my life back." Dr. Simmons expects more doctors to recognize the proper use of this medication, which he said enhances Sleep Wave sleep in patients with fibromyalgia.

If you or someone you know suffers from fibromyalgia, consider the possibility that poor sleep may be at the root of the condition. Evaluation can be provided by Dr. Simmons and his staff at CSMA's sleep centers throughout Greater Houston by calling 281-407-6222 or by visiting www.HoustonSleep.Net.