RECOMMENDED LIFESTYLE CHANGES FOR PERSONS WITH FIBROMYALGIA
Insomnia is a major issue for most people
with fibromyalgia. However, there are strategies to help improve this problem.
COGNITIVE BEHAVIOURAL THERAPY FOR INSOMNIA
There are 4 components to consider in this
category when the goal is to improve sleep quality in people living with
Reverse Unconscious Conditioning: In order to do this you should only go to bed when you feel
sleepy. It is important not to confuse feeling sleepy with feeling fatigued.
They are very different. Feeling fatigued is when you have brain fog, tired
muscles and can not do anything productive. When you feel fatigued, rest
somewhere other than your bed. This is because you want your brain to associate
being sleepy with being in bed, therefore, you should only use your bed for
going to sleep. If after 20 minutes of going to bed you are still awake then
get out of bed.
Restrict The Amount Of Time Spent In Bed To Increase Sleep Efficiency: Sleep efficiency is the
ratio of the total amount of time spent sleeping in a night versus the
total amount of time spent in bed.
Quality of sleep is more important than the quantity. Efficient sleep is more
compact as well as refreshing. Healthy sleep is associated with sleep
efficiency of 85% or higher. To increase sleep efficiency, restrict time in bed
to Total Sleep Time plus 30 minutes. To
estimate Total Sleep Time determine how much sleep you are getting each night
and then determine what time you would like to wake up. To accurately determine
how much you sleep each night, chart your sleep for 2 weeks and calculate your
nightly sleep average. For example, if you sleep an average of 5 hours a night,
add on an extra 30 minutes for the time it may take you to actually fall
asleep. Therefore, TST would equal 5 1/2 hours. If you want to be awake at 6:00
a.m., you would go to bed 12:30 a.m. The
time you wake up in the morning is more important than the time you go to bed. If you have hypersomnia and require more
than 9 hours of sleep, do not deprive yourself of sleep and attempt to wake
Calm The Mind And Body: The best quality of sleep is achieved when the autonomic nervous system is in a calm state. In order to keep a calm mind and body
before bed, it is important to try and limit any “constructive worries” for day time hours. This also means
leaving stressful or “spoon draining”
activities for this time as well. If you do too much during the day beyond your energy envelope this will
affect your sleep. Too much daytime activity increases your adrenaline
which remains heightened at night.Pace
yourself and stay within your limits.Aim to do an activity that is enjoyable and calming before bed. Avoid looking at blue light screens (cell phones, iPads, TV, sunshine,
etc.) one hour before going to bed. Blue
light is stimulating, therefore, it does not promote relaxation. On the other
hand, exposing yourself to blue light during daytime hours helps to set your circadian rhythm. Paced breathing and mindfulness exercises promote relaxation and are of benefit to many people also.
Examine Feelings of Anxiety Around Sleep/Bust Myths:
Myth: Spending more time in bed, even if not sleeping, will help me to
feel better the next day.
Fact: Spending time in bed awake
is counterproductive. You want your brain to associate being asleep with being in bed. This includes making
sure naps are in bed.
PLEASE NOTE: Some people do need
at least 8 hours of sleep or more. This is dependent on illness severity. If you need to nap in the
daytime, then take one. REMEMBER: Do not deprive
yourself of sleep if you have hypersomnia. You will only experience setbacks if you are not listening to your
Myth: Insomnia is caused by a
Fact: There are many causes of
insomnia, ranging from illnesses that are that are psychiatric to neurological. Stress, medications, certain personality traits, such as perfectionism, and other sleep disorders,
such as sleep apnea are all contributing factors in developing insomnia.
Here is a list the most commonly
prescribed medications that are effective for sleep in people with
fibromyalgia. A doctor’s prescription is needed for all of the medications
How effective the medication is, depends on
the person taking it. Everyone responds differently to prescription drugs.
There are other sleep medications, however, the ones mentioned in this list are
generally the most helpful for fibromyalgia patients.
NATURAL SLEEP AIDS
Some people prefer to try natural
alternatives, before considering prescribed medication, as an option. Sleep
aids that have proven most effective for fibromyalgia are: Melatonin,
L-Theanine, and 5 HTP.
CANNABIS FOR SLEEP
There are various strains of medical
marijuana with different amounts of THC and CBD. The effect on sleep is
dependent on the strain, components, dose, and how the cannabis is delivered.
The effect on sleep has mixed results. It is highly suggested if you would like
to try marijuana for sleep that you consult an expert in this field as there
are thousands of variants and strains.
Pathways to Improvement
Course: Pathway 3 - Sleep; Dr. Eleanor Stein
Let Your Light Shine
Through (Manual): Session #2 – Sleep (pg. 2-3 to 2-22) ; Dr. Eleanor Stein