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Fibromyalgia and Sleep
Are you having trouble sleeping because you have fibromyalgia? Most people with fibromyalgia complain of trouble sleeping. No matter how long they sleep, it is rarely restful. Here's some information that can help you get a better night's sleep.
What sleep problems are common with fibromyalgia?
Sleep problems with fibromyalgia include insomnia or difficulty falling asleep as well as frequent awakening in which you become awake enough to remember them the next day. An even more common problem is awakenings that you don't remember but that definitely interrupt your "deep" sleep. Also, other sleep disorders -- such as restless legs syndrome and sleep apnea -- may be more common in people with fibromyalgia.
People with fibromyalgia talk about waking up day after day feeling exhausted with no energy. Usually, they feel more tired in the morning, and many go back to sleep during the day to ease their fatigue. Also, it's common for people with fibromyalgia to have great difficulty concentrating during the day, a condition called "fibro fog."
Why can't I sleep at night with fibromyalgia?
Some researchers believe it's the constant pain of fibromyalgia that causes sleep interruptions. Others have found evidence that fibromyalgia may be related to an abnormality of deep sleep. Findings have shown abnormal brain waveforms in deep sleep with fibromyalgia patients. These patients tell of feeling "awake" or being in a shallow state of sleep throughout the night, instead of experiencing restful, deep- level sleep.
The problem with achieving only a shallow state of sleep is that, during deep-level sleep, your body repairs and replenishes itself. For example, studies show that people with fibromyalgia have a low level of a hormone called somatostatin. Somatostatin is produced during deep sleep and is vital for maintaining the health of muscle and other soft tissue. If the amount of deep sleep you get is reduced over a long period of time, your body may have less ability to "repair and replenish" energy as well.
What stages of sleep are important in fibromyalgia?
People with fibromyalgia lack the deep, restorative level of sleep, called "non-rapid-eye-movement" (non-REM) sleep. Consequently, patients with fibromyalgia often wake in the morning without feeling fully rested. Some patients wake up with muscle aches or a sensation of muscle fatigue as if they had been "working out" all night.
Is restless legs syndrome related to fibromyalgia?
Restless legs syndrome is a neurologic disorder characterized by an overwhelming urge to move the legs at rest. It's true that restless legs syndrome is more common among those who have fibromyalgia than in those who don't have fibromyalgia.
There is treatment for restless legs syndrome, so talk to your doctor if you have this problem.
WebMD Medical Reference
Fibromyalgia Guide
- Learn about Treatment for Moderate to Severe Rheumatoid Arthritis (RA)
- Is This RA Treatment Right For You?
- Some Fast Facts
Important Safety Information you should know about HUMIRA® (adalimumab).
Serious infections have happened in patients receiving HUMIRA. These infections include TB (tuberculosis) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections.
Before starting HUMIRA:
Tell your doctor if you think you have an infection, are being treated for an infection, have signs of an infection (such as a fever, cough, or flu-like symptoms), have any open sores on your body, have warm, red, or painful skin, get a lot of infections or have infections that keep coming back, have or had hepatitis B infection, take the medicine Kineret (anakinra), have TB or have been in close contact with someone who has TB, have lived in an area where TB or histoplasmosis is common, or were born in, lived in or traveled where there is more risk for getting TB. Your doctor should test you for TB before starting HUMIRA. If your doctor prescribes any medicine for the treatment of TB, you should start taking it before starting HUMIRA and take the full course of TB medicine prescribed.
Tell your doctor if you have any numbness or tingling, or have a disease that affects your nervous system such as multiple sclerosis or Guillain-Barré syndrome, have heart failure or other heart conditions, are scheduled for major surgery, are pregnant, become pregnant, plan to become pregnant or are breastfeeding. Tell your doctor if you are allergic to HUMIRA or any of its ingredients or are allergic to rubber or latex. The needle cover of the prefilled syringe and the pen contain dry natural rubber.
Also, tell your doctor if you have recently received or are scheduled for any vaccines. Except for live vaccines, patients may still receive vaccines while on HUMIRA. It is recommended that children with juvenile idiopathic arthritis be brought up to date with all immunizations prior to starting HUMIRA.
After starting HUMIRA:
Call your doctor right away if you get an infection, or any sign of an infection including a fever, feeling very tired, cough, flu-like symptoms, warm, red or painful skin or if you have any open sores on your body. HUMIRA can make you more likely to get infections or make any infection that you may have worse.
Possible side effects of HUMIRA:
Serious side effects, which sometimes lead to death, have happened in patients taking HUMIRA.
- Serious infections. These infections include TB (tuberculosis) and infections caused by viruses, fungi, or bacteria. Your doctor will examine you for TB and perform a test to see if you have TB. If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with HUMIRA and during treatment with HUMIRA. Even if your TB test is negative your doctor should carefully monitor you for TB infections while you are taking HUMIRA. Patients who had a negative TB skin test before receiving HUMIRA have developed active TB. Tell your doctor if you have any of the following symptoms while taking or after taking HUMIRA: cough, low-grade fever, weight loss, or loss of body fat and muscle.
- Certain types of cancer. There have been cases of certain kinds of cancer in patients taking HUMIRA or other TNF blockers. Patients with RA, especially more serious RA, may have a higher chance for getting a kind of cancer called lymphoma. Some patients receiving HUMIRA have developed types of cancer called non-melanoma skin cancer (basal cell cancer and squamous cell cancer of the skin), which are generally not life threatening if treated. Tell your doctor if you have a bump or open sore that doesn't heal.
- Allergic reactions. Signs of a serious allergic reaction include skin rash, a swollen face, or trouble breathing.
- Hepatitis B virus reactivation in patients that carry the virus in their blood. Tell your doctor if you have any of the following symptoms: feel unwell, poor appetite, fatigue, fever, rash or joint pain.
- Nervous system problems. Signs and symptoms include: numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
- Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
- New heart failure or worsening heart failure you already have. Symptoms include shortness of breath or swelling of your ankles or feet, or sudden weight gain.
- Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
Call your doctor or get medical care right away if you develop any of the above symptoms. Your treatment with HUMIRA may be stopped.
Common side effects of HUMIRA are: injection site reactions (redness, rash, swelling, itching or bruising), upper respiratory infections (sinus infections), headaches, rash and nausea.
These are not all the side effects with HUMIRA. Ask your doctor or pharmacist for more information.
Information You Should Know About HUMIRA® (adalimumab).
HUMIRA is used to reduce the signs and symptoms of moderate to severe rheumatoid arthritis in adults, may prevent further damage to your bones and joints, and may help your ability to perform daily activities. HUMIRA can be used alone or with methotrexate or with certain other medicines. HUMIRA is used to reduce the signs and symptoms of moderate to severe polyarticular juvenile idiopathic arthritis in children 4 years of age and older. HUMIRA can be used alone or with methotrexate or with certain other medicines. HUMIRA is used to reduce the signs and symptoms of psoriatic arthritis in adults, may prevent further damage to your bones and joints, and may help your ability to perform daily activities. HUMIRA can be used alone or with certain other medicines. HUMIRA is used to reduce the signs and symptoms of ankylosing spondylitis in adults. HUMIRA is used to reduce the signs and symptoms of moderate to severe Crohn's disease in adults who have not responded well to conventional treatments. HUMIRA is also for these adults with moderate to severe Crohn's disease who have lost response or are unable to tolerate infliximab. HUMIRA is used to treat moderate to severe chronic (lasting a long time) plaque psoriasis in adults who are under the ongoing care of a physician, have the condition in many areas of their body and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills).
HUMIRA is taken by injection.
64S-154126
ORENCIA® (abatacept) Important Safety Information
Indication and Usage
ORENCIA® (abatacept) is a prescription medicine that reduces signs and symptoms in adults with moderate to severe rheumatoid arthritis (RA), including those who have not been helped enough by other medicines for RA. ORENCIA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
Important Safety Information About ORENCIA® (abatacept)
Before you receive treatment with ORENCIA, a lyophilized powder for intravenous infusion, you should tell your doctor about all your medical conditions, including if you:
- have any kind of infection even if it is small (such as an open cut or sore) or an infection that is in your whole body (such as the flu).
- have an infection that will not go away or a history of infections that keep coming back.
- have had tuberculosis (TB), a positive skin test for TB, or if you recently have been in close contact with someone who has had TB. If you get any of the symptoms of TB (a dry cough that doesn’t go away, weight loss, fever, night sweats), call your doctor right away. Before you start ORENCIA, your doctor may examine you for TB or perform a skin test.
- have or have had viral hepatitis. Before you use ORENCIA, your doctor may examine you for hepatitis.
- have a history of chronic obstructive pulmonary (lung) disease (COPD).
- are scheduled to have surgery.
- are allergic to any of the following ingredients in ORENCIA: abatacept, maltose, monobasic sodium phosphate, or sodium chloride for administration.
- recently received a vaccination or are scheduled for any vaccination.
- have diabetes and use a blood glucose monitor to check your sugar levels. The infusion of ORENCIA contains maltose, a sugar that can give falsely high blood glucose readings with some monitors on the day you receive your infusion. Your doctor may tell you to use a different way to monitor your blood sugar levels.
- are pregnant, planning to become pregnant, or are thinking about becoming pregnant. It is not known if ORENCIA can harm your unborn baby.
- are breast-feeding. You will need to decide to either breast-feed or receive treatment with ORENCIA, but not both.
- take any other kinds of medicine, including prescription and nonprescription medicines, vitamins, and herbal supplements.
- are taking other biologic medicines to treat RA such as: Enbrel® (etanercept), Humira® (adalimumab), Remicade® (infliximab), Kineret® (anakinra) or Rituxan® (rituximab). You may have a higher chance of getting a serious infection if you take ORENCIA with other biologic medicines.
Possible Side Effects of ORENCIA® (abatacept)
ORENCIA can cause serious side effects including:
- Serious infections. Patients receiving ORENCIA have a higher chance of getting infections including pneumonia, and other infections caused by viruses, bacteria, or fungi. Call your doctor immediately if you feel sick or get any of the following signs of infection: fever, feel very tired, cough, feel flu-like, or warm, red or painful skin.
- Allergic reactions. Allergic reactions can happen on the day of treatment or the day after receiving ORENCIA. Tell your doctor or get emergency medical help right away if you have hives, swollen face, eyelids, lips, tongue, throat, or trouble breathing.
- Cancer (malignancies). Certain kinds of cancer have been reported in patients receiving ORENCIA. It is not known if ORENCIA increases your chance of getting certain kinds of cancer.
- Vaccinations. You should not receive ORENCIA with certain types of vaccines. ORENCIA may cause some vaccinations to be less effective.
- Respiratory problems in patients with COPD. You may get certain respiratory problems more often if you receive ORENCIA and have COPD, including: worsened COPD, pneumonia, cough, or trouble breathing.
The more common side effects with ORENCIA are headache, upper respiratory tract infection, sore throat, and nausea.
Please read the Patient Information in the Full Prescribing Information below.
ORENCIA is a registered trademark of Bristol-Myers Squibb Company.
All other trademarks are property of their respective companies.
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Millions of American workers start their work day after 6 p.m., fending off sleep. One drug may make staying awake less tiring.
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