(FM) and sleep dysfunction seem to go hand in hand. In fact, most people who
have FM complain of problems associated with sleeping. Sleep problems can
include difficulty falling asleep with or without waking up one to multiple
times a night. Also, the inability to reach “deep sleep” results in waking up
un-restored. People with fibromyalgia frequently state, “… I feel exhausted
when I wake up; I have no energy.” They often feel more tired in the morning,
and many go back to sleep during the day to ease their fatigue. Another common
FM complaint is having great difficulty concentrating during the day, often
referred to as, “…fibro fog.” Other sleep disorders such as sleep
apnea and restless leg syndrome are also often associated with FM.
Restless legs syndrome (RLS) is a
neurologic disorder that is characterized by an overwhelming urge to move the
legs at rest, thus interfering with sleep. Restless legs syndrome is more
common among those who have fibromyalgia. Patients with RLS describe this as an
unpleasant sensation in their legs and sometimes their arms or other parts of
the body accompanied by the irresistible urge to move the legs in attempt to
relieve the sensation. The terms, “itchy” or “pins and needles” or “creepy
crawly” are frequently used when describing the sensations and can range from
mild to intolerable. Symptoms are typically worse at rest, especially when
lying or sitting and frequently results in sleep deprivation and stress. The
intensity of the symptoms can vary, frequently worse in the nighttime, better
in the morning. RLS may affect up to 10% of the population in the United States,
especially women, and can affect both young and old, even young children. The
severe cases usually affect the middle-aged or older and account for about 2-3%
of the 10% incident rate. The diagnosis is often delayed, sometimes for 10-20
years. Although the cause is not clearly described, genetics seems to play a
role given about 50% of those affected have a family member with the condition.
Other conditions often associated
with RLS include iron deficiency, Parkinson’s disease, kidney failure, iron
deficiency, diabetes and peripheral neuropathy. Treatment applied to these
conditions often indirectly helps RLS resulting in sleep quality improvement.
Medications such as anti-nausea drugs, antipsychotic drugs, some
anti-depressants, and cold/allergy medications that contain antihistamines can
worsen symptoms. Pregnancy can also trigger RLS, especially in the last
trimester. It commonly takes about 3-4 weeks for the symptoms to quiet down
after delivery. Other factors that affect RLS include alcohol intake and sleep
deprivation itself. Improving sleep and/or eliminating alcohol can be quite
effective treatment strategies. There are no medical tests that confirm the
diagnosis of RLS, but blood tests can at least rule out other conditions, and
when all the tests are negative, the diagnosis is made based on a patient’s
symptoms, family history, medication use, the presence of an interrupted sleep
pattern with daytime fatigue, and knowledge about the condition.
Treatment utilizing chiropractic
management has been reported to be effective in managing RLS associated
symptoms including the use of spinal manipulation, muscle release techniques,
exercise training, and at times, physical therapy modalities. Nutritional
approaches that emphasize muscle relaxation have also been reportedly helpful.
If you, a friend or family member
requires care for FM, we sincerely appreciate the trust and confidence shown by
choosing our services!
To schedule an appointment with one of our San Francisco Fibromyalgia Doctors call 415-392-2225. Mention this article for a complimentary consultation.