Insomnia and Fibromyalgia

I used to cherish sleep. Sleep and I were best friends. I would look forward to sleep like I would look forward to a giant piece of chocolate cake. I could climb into bed at any hour, sleep for 8 hours and wake up refreshed and ready to go. I was a morning person in my former life and it use to tick my husband off. I LOVED sleep. Then my life changed.

Two years ago, I started to have problems. I would toss and turn all night just trying to find a comfortable spot. I would frequently wake up at 2am and have difficulty falling back asleep. When I would wake up, I just would stare at the back of my husbands head, wishing I could sleep as soundly (but not as loudly) as he did. It was harder for me to get up and moving in the morning.

I started to notice several changes. I did not have the energy to complete a full days worth of work. I started to feel short of breath anytime I had to physically exert myself. I experienced pain more frequently. My mood changed also, I was short tempered and had no patience.

At first, I thought it was my bed. It was 10 years old and if you believe those mattress commercials, then you should get a new one every 8 years. We bought one of those fancy Tempurpedic mattresses. It felt really soft and comfortable in the store but when we got it home, it was hard as a rock.  The salesmen said that we needed to loosen up the cells of the mattress by jumping on it. So for 3 weeks, my 250lb husband and I jumped on the mattress twice a day. As fun as that was, It didn’t help. We returned it and purchased a Serta pillow top. It was a slight improvement and no jumping was needed. The only thing that helped was adding on a four inch memory foam topper from Costco. Despite all of these changes, I still wasn’t sleeping well.

This is around the time that my doctor and I started to discuss fibromyalgia and it dawned on me that all of this was connected. Fibromyalgia sufferers frequently experience non-resortative sleep. It is not uncommon to have difficulty falling or staying asleep. It is a vicious cycle, pain makes it more difficult to sleep but sleep helps decrease pain and restore function. Not to mention all the other side effects of decreased sleep including decreased energy, irritability, depression and increased fibro fog.

My doctor and I tried multiple treatments for insomnia. At first, we tried a high dose melatonin supplement. That did nothing for me. Next, we tried Trazodone. That worked great for my insomnia and I woke up feeling like a million bucks. However, the side effects, including dry mucous membranes, were unbearable and I stopped taking it after a couple weeks. Desperate for relief, we turned to Ambien.

I was really worried about trying Ambien. I had heard multiple stories of the side effects. My boss had told me about the time that her partner had driven the car and crashed it into the garage door while on the medication and not remembering anything. Yikes! So that first night, I tucked myself in tight and told my husband that if I got up in the middle of the night to make sure I didn’t go anywhere. Not the most helpful suggestion, when you are married to a heavy sleeper like my husband.

I was on Ambien for about a week and a half with only mild relief of my symptoms. To my knowledge, I never experienced any of the sleep walking that I had feared. However, it severely worsened my depression. I started having some very dark thoughts that are still very difficult to share. Fortunately, I was able to recognize that they were associated with the drug and I stopped it immediately and got myself into my therapist’s office.

So now what do I do? I am out of medicinal options and I still can’t sleep. Well what worked for me, is a combination of pain medicine, anti-anxiety medicine and something called cognitive behavioral therapy.

In regards to my medication, I currently take 600 mg of Gabapentin at bed time along with my Cymbalta, vitamin D, fish oil, and vitamin C. If I am having a particularly bad night then I will take a small amount of alprazolam to turn my brain off and quiet my legs. As a reminder, this is what works for me. Any medications, should be discussed with your regular physician.

Let’s change gears to cognitive behavioral therapy. CBT is basically changing the way that you look and do something. It is creating new, positive habits usually with the help of a mental therapist. I like to think of it as going back to school to retrain your brain.

Here are some of the things that have helped me improve my sleep…

TIPS FOR GETTING A BETTER NIGHT’S SLEEP

1. Make it a habit – Try to go to bed and wake up around the same time each day.

2. Your bed should only be used for sleep and sex – Don’t watch TV or read in bed. The goal is to teach your brain to turn off when it is in bed.

3. Sleep mask – Studies have shown that a deeper sleep can be accomplished with increased darkness. I live in the suburbs of Chicago and there is a lot of light pollution. I thought about getting black out shades but I have a cat that is always trying to look out the window and he can be pretty noisy about it. So I compromised and got a nice sleep mask. It works great if my husband stays up a little bit later and comes up stairs and turns all the lights on too.

4. No caffeine or other stimulants after noon – I am pretty sensitive to caffeine but sometimes I need a little to get moving in the morning. However, I make sure to stop drinking tea after 12pm. This goes for other stimulants like chocolate or decongestants.

5. Avoid alcohol before bed – Alcohol can have a sedative effect for the first few hours, however, it does not provide a restful night sleep.

6. Start to wind down an hour before bedtime – Turn the television off and relax in a comfortable chair. This is a great time to journal or just mentally recap the day in your mind. If you are someone that normally lays in bed worrying about tomorrow, then this is a great time to do that before your head hits the pillow. It also helps to dim the lights in the house and play some relaxing music.

7. Leave a notebook next to the bed for last minute thoughts – It never fails. I tuck myself into bed and get a last minute idea. The best thing that you can do for yourself is to jot it down really quick and leave it for the next day. That way you are not trying to remember it during the night.

8. Make your bedroom as comfortable as possible – Like I mentioned earlier, I bought a thick memory foam topper for my bed and it has helped significantly. I also run a small essential oil vaporizer to fill the room with comforting scents and run a fan so I don’t overheat at night.

9. Exercise – I know that this is a tricky topic for spoonies. Experts say that if you exercise during the day and no later than 3 hours before bed that it can improve the quantity and quality of sleep. I totally get it though. I find it very difficult to exercise most days. However, if I am having a good day, I will try to get in a brisk walk or a short bike ride.

10. Deep breathing exercises and guided meditation –  Another great way to help your brain to turn off at night is with guided meditation. I frequently use a CD or you tube video, such as the one below, to help fall asleep. The soothing rain sounds also acts as a white noise machine during the night. Hint, just make sure that your bladder is totally empty when you go to bed.

I hope some of these suggestions help you get a better nights sleep. I think that insomnia is the most unfair thing about fibromyalgia. I consider it throwing salt on the wound that we already have with chronic pain and fatigue

Good Luck and sweet dreams

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