Living With Fibromyalgia and Chronic Fatigue
Lifestyle changes and the right medications can help ease
fatigue and restless sleep from fibromyalgia.
Jackie Yencha is somebody who gets things done -- as much as possible. She
has been coping with fibromyalgia and chronic fatigue most of her life. But she
pushed through college, got married, is raising two kids, and holds a top-level
volunteer position with a fibromyalgia advocacy agency. She and her family even
organize a charity golf tournament every year to honor her mother, who died of a
rare cancer.
She'd like to do more than that -- but that's just not going to happen.
Yencha is always fighting sleep problems. "I literally get sick if I don't get
sleep," she says. Even on good days, her energy level may fizzle early. "Fatigue
is my biggest problem," Yencha tells WebMD. "I've had to give up a lot of things
because of the fatigue."
Fibromyalgia and chronic fatigue syndrome are considered separate but related
disorders. They share a common symptom -- severe fatigue that greatly interferes
with people's lives.
Insomnia -- and the lack of deep, restorative sleep -- is a big part of the
problem, explains Mary Rose, PsyD, a clinical psychologist and behavioral sleep
specialist at Baylor College of Medicine in Houston.
Sleep and Fibromyalgia Fatigue
When Rose first sees a patient with fibromyalgia syndrome and chronic
fatigue, she makes sure that other causes of fatigue, like anemia (low blood
count) and thyroid problems, have been addressed.
Improving a patient's sleep is an important part of easing fibromyalgia
fatigue, Rose tells WebMD. "We know from research that sleep improves mood,
pain, and in general how people feel during the day. Regardless of the reasons
for the chronic fatigue, if we can get some control over quality of sleep, we're
likely to see positive benefits to mood, fatigue, concentration."
The chronic lack of sleep affects a patient's overall health as well as their
pain, Rose adds. "They feel lousy, exhausted, and their immune system can be
damaged."
Steven Berney, MD, chief of rheumatology at Temple University Health System
in Philadelphia, agrees. "In fibromyalgia, all treatments are geared toward
helping people sleep better," he tells WebMD. "If we can improve their sleep,
patients will get better."
Living With Fibromyalgia and Chronic Fatigue
Sleeping pills aren't the answer, says Rose. "They are intended for no more
than six weeks. It's not just that your body gets habituated to them, so you
need higher levels of the sleep drug as time goes on. The problem is that they
just don't work well with these patients."
Indeed, living with fibromyalgia is more than just popping a pill, says
Martin Grabois, MD, chairman of physical medicine and rehabilitation at Baylor
College of Medicine in Houston. "A good deal is self-treatment. Patients have to
be active, not passive."
First step: Patients may need to be checked for symptoms of snoring and
sleep-related breathing problems. Sleep apnea, respiratory problems, allergies,
and big tonsils or tongue are among the possibilities, Rose tells WebMD. "A lot
of those things can be corrected."
Living With Fibromyalgia and Chronic Fatigue continued...
What you can do. Lifestyle changes -- cutting back on caffeine,
alcohol, and smoking -- may be necessary to improve sleep. Sleep habits may need
to change. To make your bedroom more sleep-friendly, it's important to:
- Limit noise, light, and other stimuli (like pets).
- Keep the room temperature and bedding comfortable.
- Do something relaxing before bed, like listening to music or reading.
- Turn the alarm clock so it's not facing you.
If you're having trouble getting to sleep, get up and do something restful in
another room, Rose advises. "Don't lie in bed, worrying and stressing. Get up,
go to the other room. When you're calmer, relaxed, feel tired, go back to
bed."
Don't nap. Make sure your sleep time follows a regular schedule, she
adds. "A lot of patients have circadian rhythm problems. Napping can throw you
off. Any sleep during the daytime will be taken from your sleep at night."
Reduce stress. Anything that reduces stress -- yoga, Pilates,
meditation -- will help you sleep better, says Rose. It will also help normalize
heart rate and blood pressure, so you feel better. Psychological therapy,
relaxation exercises, visualization, meditation, and biofeedback can help ease
anxiety, tension, and stress.
Start stretching. Several times a day, it's important to give tight
muscles a good stretch. Before you get out of bed in the morning, start with
stretching: move your head and neck, and you’re your shoulders up and down. Make
stretching a ritual. A warm bath can make the stretch more comfortable.
Exercise. Getting regular exercise is also important, Rose says. "Any
time you have pain, insomnia, and fatigue, I always say exercise. Exercise has a
profound effect on mood, weight, and fatigue. Water exercise is easier on
joints, so it's a lot more tolerable for fibromyalgia patients."
Although physical therapy and exercise may be difficult, the short-term pain
is a trade-off, she explains. "Even though you feel a lot of pain and
discomfort, pushing yourself is important. Exercise helps reduce stress, and
that helps sleep and reduces fatigue."
Pace yourself. Moderation is important if you have fibromyalgia, says
Grabois. "When people feel good, then they tend to do too much -- then pay the
price later. Others give up on exercise altogether, because they don't sleep
well, feel fatigued, and exercise makes the fatigue worse."
Start with very low intensity exercise and build up very slowly, he advises.
"I'm not saying run around the block three times. I'm saying walk around the
block one time -- and do it on a regular basis, seven days a week."
With daily activities, it's good to set up a scheduled routine. Be careful
about overdoing it, so you don't deplete your extra energy. Learning moderation
is a skill that can help you get things done despite discomfort and fatigue.
Living With Fibromyalgia and Chronic Fatigue continued...
Try medications. Antidepressants and other medications can help
greatly in pain control, says Rose. "If your body is worn down, and you're in
pain, it's something to consider. I tell people, you can always quit taking it.
We can see if it helps."
Consider complementary therapies. Alternative therapies like massage
and acupuncture have helped some people living with fibromyalgia. Be sure to
talk to your doctor before trying natural or complementary therapies, Rose
advises.
Volunteer work, hobbies, and a social support network also help make it
easier living with fibromyalgia. So does a sense of humor.
"Anything you do to make your quality of life better -- to give you more
happiness -- you can't lose," Rose tells WebMD. "Do what brings you happiness,
and chances are it will help you refocus, get your focus away from the
pain."