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A Good Nights Sleep Poor sleep has been linked to various health problems including depression, poor immune function, anxiety, depression, weight gain, muscle pain, low thyroid, irritable bowel syndrome, fatigue, CFS, fibromyalgia, and headaches. This isnt news to those who suffer with fibromyalgia and CFS, they already know their symptoms get worse when they dont get a good nights sleep.
If you dont get a good nights sleep, youre not going to feel well. It really is that simple. Most people with chronic illnesses including those with fibromyalgia havent slept well in years.
Research One study showed that college students who were prevented from going into deep (REM) sleep for a week developed the same symptoms associated with FMS and CFS: diffuse pain, fatigue, brain fog, irritable bowel syndrome, lowered immune function, depression, anxiety, irritability, stomach disturbances, and headache.
And research presented at the Endocrine Society in San Francisco, in June 2002, showed that sleep deprivation markedly increased inflammatory cytokines (pain causing chemicals)by a whopping 40%.
Sleep Cycles. Sleep cycles follow our circadian rhythms. It has been found that the natural hormone melatonin plays a large part in mediating sleep. As darkness falls, enzymes in the brain stimulate the release of melatonin from the pineal gland in the brain. Melatonin induces sleep and then the release of melatonin is halted when daylight arrives, and we experience wakefulness. Upon falling asleep, the brain and body go through five stages of sleep in one sleep cycle. Researches have classified these stages of sleep by monitoring muscle tone, eye movements, and the electrical activity of the brain using an electroencephalogram (EEG). EEG readings measure brain waves and classify them according to speed. Alpha rhythms are the fastest waves, followed by slower beta rhythms. Theta and delta waves are the slowest. A sleep cycle lasts 90 minutes or so, during which the brain revolves through each type of EEG rhythm. This sleep cycle is repeated approximately five or six times during the course of the night and corresponds to the circadian rhythms, which we experience during the day. Most of the sleep drugs, especially the sedatives (tranquilizers) don't allow a person to go into deep (stage III and IV) restorative sleep. So they have their eyes closed while they're knocked out for 8 hours, but they don't receive the health benefits of deep restorative sleep.
They often feel hung over in the morning and have to rely on stimulant drugs or beverages to get them going. This cycle often further interferes with their sleep/wake cycle, especially if they consume caffeinated beverages throughout the day.
In fact many of these sleep drugs actually deplete the bodys own natural sleep hormone, melatonin.
Warning: Your Sleep Drug May be doing More Harm Than Good.
Prescription Drugs that may be used for sleep disorders include the following:
Ambien (zolpidem) is a short-acting drug that usually lasts for foursix hours. If a patient takes a half dose before bed, then he can take an additional half dose if needed foursix hours later. Even though the literature on Ambien suggests patients don't build up a tolerance, many do. Some patient's do well on Ambien; some build up a tolerance over a period of time needing higher and higher doses until the medicine no longer works. It does promote deep restorative sleep. However, the side effects are similar to fibromyalgia and CFS.
Side Effects: Short-term memory loss, fuzzy thinking, sedation or next day hang over, mood disorders (anxiety and depression), flu-like symptoms, muscle aches and pains, and in-coordination (clumsy). Ambien may cause fatigue, headache, difficulty sleeping, and memory loss. Long-term use (2 weeks or more) can result in constipation, upset stomach, joint pain, upper respiratory infections (URI), sore throat, urinary infection, and heart palpitations.
Lunesta (eszopiclone) is similar to Ambien.
Side effects include the following: Allergic reactions (itchy, watery eyes, rash, difficulty breathing, swelling of face, tongue, or throat), confusion, anxiety, depression, hallucinations (seeing, hearing, or feeling things that are not really there), lightheadedness, fainting spells, or falls, sleepwalking or performing other activities while asleep, slurred speech or difficulty with coordination, vision changes, restlessness, excitability, or feelings of agitation, dizziness, or daytime drowsiness, sometimes called a 'hangover' effect, headache, strange dreams, bad taste, and slight stomach pain. It does promote deep restorative sleep. But, once again look at the potential side effects.
Tricyclic Antidepressants Doxepin, Elavil, Trazadone, Amitriptyline, Despramine, Imipramine, Pamelor, etc. Tricyclic antidepressants block the hormones serotonin and norepinephrine. This produces a sedative effect. These drugs do promote deep restorative sleep. But as youll read below, they are associated with numerous unwanted side effects.
Like other antidepressant medications, these drugs are processed by the liver and can cause liver toxicity. These drugs deplete the natural sleep hormone melatonin and CoQ10. Anyone taking tricyclic antidepressants, beta-blockers and or statin drugs should be taking CoQ10 on a daily basis. These drugs deplete CoQ10. Co Q10 is vital for proper heart, brain, muscle, and liver function. Low levels of CoQ10 can cause a host of unwanted symptoms including fatigue, muscle pain, high blood pressure, congestive heart failure, brain fog, tingling in the hands and feet, swelling, brain fog, and mood disorders. Common side effects include upset stomach, constipation, bad taste in the mouth, heartburn, diarrhea, rash, rapid heartbeat, mental confusion, hostility, swelling in the arms or legs, dizziness, nightmares, drowsiness, and fatigue.
Tricyclic antidepressants promote deep stage 3 and 4 restorative sleep. And so does the muscle relaxant Flexeril (see below) that is similar to Elavil.
However, no one suffers with a drug deficiency. All of these drugs have potential side effects.
Muscle Relaxants
Flexeril (cyclobenzaprine) is a muscle relaxant chemically similar to the antidepressant Elavil. It is sometimes used as a sleep aid. Flexeril does allow the patient to go into deep stage four (restorative) sleep. It is quite sedating. It does promote deep restorative sleep.
Side Effects: Side effects, including gastritis and a feeling of being hung-over or out of touch, prevent most patients from remaining on this drug for very long.
Baclofen (lioresal) is a muscle relaxant similar to the natural neurotransmitter GABA.
Side Effects: include fatigue, drowsiness, low blood pressure, weakness, dizziness, nausea, headache, depression, weight gain, and insomnia. Does not promote deep, restorative sleep.
Zanaflex (tizanidine) is a muscle relaxant that has gained some popularity among physicians treating FMS. It is sedating but it doesnt produce deep, restorative sleep. And it doesnt help increase serotonin levels; it only tranquilizes the nervous system. For this reason alone it should be avoided.
Side Effects: Zanaflex is associated with numerous side-effects, including liver failure (at least three individuals have died from taking this medication), asthenia (weakness), somnolence (prolonged drowsiness or a trance-like condition that may continue for a number of days), dizziness, UTI (urinary tract infection), constipation, liver injury, elevated liver enzymes, vomiting, speech disorder, blurred vision, nervousness, hypotension, psychosis/hallucinations, bradycardia (slow heart action), pharyngitis (sore throat), and dyskinesia (defect in voluntary movements). The stuff is poison!
Atypical Sleep Drugs
Sonata (zaleplon) is designed to last for only four hours; this helps prevent morning hangover. Ive not found it to be very effective, though, since most of my patients have trouble sleeping through the night, not just with getting to sleep. Does not promote deep restorative sleep.
Side Effects: Abdominal pain, amnesia, dizziness, drowsiness, eye pain, headache, memory loss, menstrual pain, nausea, sleepiness, tingling, and weakness.
Ramelteon, marketed, as Remerem is the first in a new class of sleep agents that selectively binds to the melatonin receptors. This drug is designed to help a person use their natural melatonin more effectively. No published studies have indicated whether ramelteon is more or less safe or effective than over the counter melatonin (melatonin certainly costs less). This drug does promote deep restorative sleep. However, look at the potential side effects.
Side Effects: Drowsiness, fatigue, dizziness, head pain, depression, acute infection of ear, nose, throat, joint pain, muscle pain, trouble sleeping, and diarrhea.
I recommend taking melatonin and avoid all these potential side effects. The makers of this drug like to tout that this drug is standardized and is a higher quality product than the melatonin supplements you can get over the counter. There several high quality, pharmaceutical grade melatonin supplements available over the counter. And at $10 compared to $200 plus for a months supply of Remerem, melatonin is not only safer, often more effective, but substantially less expensive.
Fortunately this is a better way to help restore deep restorative sleep in those with fibromyalgia. Boosting serotonin levels with 5HTP helps reduce pain, boost moods, reverse IBS, increase melatonin levels by 200%, and perhaps most importantly, promote deep restorative sleep.
Individuals with low serotonin will experience the following: It's hard for you to go to sleep. You can't stay asleep. You often find yourself irritable. Your emotions often lack rationality. You occasionally experience unexplained tears. Noise bothers you more than it used to. It seems louder than normal. You "flare up" at others more easily than you used to. You experience unprovoked anger. You feel depressed much of the time. You find you are more susceptible to pain. You prefer to be left alone. Answering yes to 3 or more of these statements above suggests youre low in serotonin.
To find out if youre low in serotonin take the online Brain Function Questionnaire below:
http://www.fibromyalgiacfsstore.com/brainfunc.html
The most important thing in overcoming fibromyalgia is deep restorative sleep. Work with a doctor or health care professional familiar with natural sleep aids before trying a prescription drug. But if you find you cant sleep taking a more natural approach then by all means take the appropriate prescription sleep drug. About Dr. Murphree
Dr. Murphree is a board certified nutritional specialist and chiropractic physician who has been in private practice since 1990. He is the founder and past clinic director for a large integrated medical practice located on the campus of Brookwood Hospital in Birmingham Alabama. The clinic was staffed with medical doctors, chiropractors, acupuncturists, nutritionists, and massage therapists. The clinic combined prescription and natural medicines for acute and chronic illnesses. He is the author of 5 books for patients and doctors, including "Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome," ""Heart Disease What Your Doctor Won't Tell You and "Treating and Beating Anxiety and Depression with Orthomolecular Medicine."
In 2002 Dr. Murphree sold his medical practice and now maintains a busy solo practice specializing in fibromyalgia, chronic fatigue syndrome, heart disease, mood disorders, and other chronic illnesses. He can be reached toll free 1-888-884-9577 or at 205-879-2383 His website is at www.treatingandbeating.com for more information about Dr. Muphree and fibromyalgia treatingandbeating.com
