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Fibromyalgia Pain at Night
Do you toss and turn at night because of fibromyalgia pain or discomfort?
"People with fibromyalgia tend to have very disturbed sleep," says Doris Cope, MD, director of Pain Management at the University of Pittsburgh School of Medicine. "Even if they sleep 10 hours a night, they still feel fatigued, don't feel rested."
Research shows that with fibromyalgia, there is an automatic arousal in the brain during sleep. Frequent disruptions prevent the important restorative processes from occurring. Growth hormone is mostly produced during sleep. Without restorative sleep and the surge of growth hormone, muscles don’t heal and neurotransmitters (like the mood chemical serotonin) are not replenished. The lack of a good night’s sleep makes people with fibromyalgia wake up feeling tired and fatigued.
The result: The body can't recuperate from the day's stresses -- all of which overwhelms the system, creating a great sensitivity to pain. Widespread pain, sleep problems, anxiety, depression, fatigue, and memory difficulties are all symptoms of fibromyalgia.
Insomnia takes many forms -- trouble falling asleep, waking up often during the night, having trouble going back to sleep, and waking up too early in the morning. Smoothing out those sleep problems -- and helping people get the deep sleep their bodies need -- helps fibromyalgia pain improve significantly, research shows.
Medications can help enhance sleep and relieve pain. But doctors also advocate lifestyle changes to help sleep come naturally.
Tips to Get Better Sleep With Fibromyalgia
Creating a comfort zone at home is key to better sleep, whether you have fibromyalgia or not. It's all about easing into bedtime feeling relaxed -- and staying relaxed so you sleep through the night.
These 10 tips can help people sleep better:
- Enjoy a soothing (warm) bath in the evening.
- Brush your body with a loofah or long-handled brush in the bath.
- Ease painful tender points with a self-massage device (like a tennis ball).
- Do yoga and stretching exercises to relax.
- Listen to calming music.
- Meditate to tame intrusive thoughts and tension.
- Sleep in a darkened room. Try an eye mask if necessary.
- Keep the room as quiet as possible (or use a white-noise machine).
- Make sure the room temperature is comfortable.
- Avoid foods that contain caffeine, including teas, colas, and chocolate.
Therapies to Treat Insomnia When You Have Fibromyalgia
If you're still having sleep problems, several therapies can help, including biofeedback, relaxation training, stress reduction, and cognitive therapy. A psychologist who specializes in sleep disorders can discuss these therapies with you.
The therapies help people handle stress better, which helps control fibromyalgia episodes, Cope says. "Fibromyalgia comes and goes," she tells WebMD. "When you're stressed out, that's when it's worse." That's when you're most likely to have insomnia, too.
Medications can also help ease fibromyalgia pain at night, or directly treat insomnia. Medications to ease fibromyalgia at night include antidepressants, anticonvulsants, prescription pain relievers, and sleep aids.
No one therapy will control fibromyalgia pain 100%, Cope adds.
"Medications help some. Exercise helps some. Stress reduction helps some. Cognitive behavior therapy helps some... If you can get restful sleep, you're going to function better when you're awake."
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Important Safety Information About Cymbalta
Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.
What should I talk about with my healthcare provider?
Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.
Who should NOT take Cymbalta?
You should not take Cymbalta if:
- You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
- You have uncontrolled narrow-angle glaucoma (increased eye pressure)
- You are taking Mellaril® (thioridazine)
What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, talk with your healthcare provider:
- about all of your medical conditions, including kidney or liver problems, glaucoma, diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or the control of blood sugar in some patients with diabetes
- about your alcohol use
- if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life-threatening condition
- if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
- if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant
While taking Cymbalta, talk with your healthcare provider:
- if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
- if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
- before stopping Cymbalta or changing your dose
- if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose.
- about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
- if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady while taking Cymbalta which may be signs of low sodium levels
- if you develop problems with urine flow
If you have any questions, talk to your healthcare provider before taking Cymbalta.
What are the possible side effects of Cymbalta?
In clinical studies of depression, the most common side effect of Cymbalta was nausea. Other common side effects included dry mouth, constipation, decreased appetite, fatigue, sleepiness, and increased sweating. This is not a complete list of side effects.
Other safety information about Cymbalta:
Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you should not drive a car or operate hazardous machinery.
See Prescribing Information for additional Important Safety Information, including Boxed Warning.
