Do you wake up feeling exhausted even after sleeping all night and feel as if you have hardly slept at all? It’s poor quality sleep. Non-restorative sleep (NRS), also called unrefreshing sleep, is the number one sleep disorder in people with fibromyalgia.
It is estimated that 80% of people with fibromyalgia have NRS. Brainwave studies have found that fibromyalgia patients lack restorative levels of deep sleep.
People with fibromyalgia show less deep (delta) sleep, increased lighter stages (alpha) of sleep, and wake up frequently during the night. The lack of restorative (delta) sleep is why you might sleep 8 hours, yet wake feeling unrefreshed.
The impact of non-restorative sleep can go well beyond feeling tired. Research links this poor-quality sleep to multiple symptoms of fibromyalgia, including:
- Increased tenderness
- Lack of overnight recovery from pain
- Cognitive impairment (fibro fog)
- Poor performance of tasks
- Morning achiness and stiffness
- Psychological distress
The 4 Stages of Sleep
Previously, experts divided sleep into five different stages. Stages 3 and 4 were combined so now there are four stages of sleep.
There are 4 stages of sleep in the course of a normal nights rest:
- Stage 1 is the beginning of the sleep cycle. It is light sleep where you drift in and out of sleep and can be awakened easily. In this stage, the eyes move slowly and muscle activity slows. This period of sleep lasts only a brief time (around 5-10 minutes).
- Stage 2 is the second stage of sleep and lasts for approximately 20 minutes. Eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves.
- Stage 3 is referred to as deep sleep or delta sleep. It is during these deepest levels of sleep that the body restores and refreshes itself.
- REM (Rapid Eye Movement) is when dreaming occurs. REM sleep is characterized by eye movement, increased respiration rate, and increased brain activity.
Sleep begins in stage 1 and progresses into stages 2 and 3. After stage 3 sleep, stage 2 sleep is repeated before entering REM sleep. Once REM sleep is over, the body usually returns to stage 2 sleep.
Sleep cycles through these stages approximately four or five times throughout the night. A complete sleep cycle takes an average of 90 minutes.
The first sleep cycles each night have relatively short REM sleeps and long periods of deep sleep but later in the night, REM periods lengthen and deep sleep time decreases.
How Does Non-restorative Sleep Relate To Fibromyalgia
Many fibromyalgia sufferers either don’t reach deep sleep, or they don’t stay there for long. Instead, alpha waves return, indicating that part of the brain is improperly active at that time.
Research suggests that people with fibromyalgia are constantly aroused by bursts of brain activity that limits the amount of time spent in deep-stage restorative sleep.
One theory as to why is that brain chemicals are out of whack. There is evidence that fibromyalgia is associated with abnormal levels of neurotransmitters (dopamine, serotonin and substance P) and hormonal imbalances (growth hormone, cortisol).
In addition to interfering with restful sleep, neurochemicals and hormonal imbalances may increase the pain associated with fibromyalgia.
Does Fibromyalgia Cause NRS Or Does NRS Cause Fibromyalgia?
A recent study in Norway suggests that non-restorative sleep could cause women to develop fibromyalgia. This article, Fibromyalgia Risk Greater Among Females With Poor Sleeping Habits at Medical News Today gives more information about the study.
Trouble sleeping came long before I developed any other symptoms of fibromyalgia. What about you? What came first, poor sleep or fibromyalgia?