Non-Restorative Sleep In Fibromyalgia

Non-restorative sleep (NRS) is the number one sleep disorder in people with fibromyalgia. Also called unrefreshing sleep, non-restorative sleep is about the quality of your sleep. Even after sleeping for a full night, you wake up feeling exhausted and as if you have hardly slept at all. Brain wave studies have found that fibromyalgia patients lack the restorative levels of deep sleep. It is estimated that 80% of people with fibromyalgia have Non-Restorative Sleep disorder.

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
Fatigue
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.

In modern society, people commonly experience sleep that is not refreshing, waking each morning reluctant to get out of bed and struggling through the day. In addition to feeling tired or sleepy, unrefreshing sleep has an impact on concentration and memory, mood and irritability, so as well as health effects it can affect our work performance and how we interact with family and friends.

What can cause unrefreshing sleep?

Many things can result in unrefreshing sleep, but common causes are depression or stress and anxiety. Over 70% of people with depression report poor quality sleep, and recent research shows if poor sleep associated with depression or anxiety is addressed not only does sleep improve, but depression and anxiety are also improved. It had been thought that treating depression itself would also improve sleep, but we now know that specific sleep treatment is required.
Dealing with stress is part of modern life. However, if we take stress to bed, even though we may sleep, there are subtle changes to sleep that occur with stress that can make it unrefreshing. It is important to allow enough time at the end of the day to wind down before getting into bed, and if stress is a problem, then setting aside time for relaxation or meditation before bed can improve the quality of sleep.
Medical conditions and sleep disorders can cause unrefreshing sleep
Medical illnesses and the medications used to treat them can also cause unrefreshing sleep. Chronic pain, or severe heart or lung problems cause constant sleep disruption. Whilst chronic inflammatory conditions such as rheumatoid arthritis or chronic infections such as hepatitis or HIV also cause unrefreshing sleep and fatigue through sleep-promoting components of the immune response – cytokines. These same cytokines are what make us have to take to bed with a cold or flu and make sleep for much longer than usual during these acute infections.
Specific sleep disorders such as sleep apnea and leg movements during sleep are common causes of unrefreshing sleep, and these regularly occur together with medical illness or depression, worsening sleep even further. Looking at the contribution of sleep disorders to unrefreshing sleep is the role of a sleep study in evaluating the symptom of unrefreshing sleep.

Unrefreshing sleep, whilst common, usually has an underlying cause. By identifying and treating that cause, daytime function can be improved.

Hello Amy, here are some facts that i have pulled up for you.
Fatigue: Those with fibromyalgia experience a crippling, intense form of fatigue. It's not fatigue in the sense where you feel tired after a long day at the office. It's such a potent type that many people feel equally as tired when they wake in the morning as they did when they went to bed the night before. For this reason, fibromyalgia is often connected to chronic fatigue syndrome. Such exhaustion tends to aggravate other symptoms, especially pain. Problems sleeping: Research shows that fibromyalgia patients experience bursts of brain activity in the deep stages of sleep. These disturbances prevent patients from achieving a restful and restorative night's sleep. Pain, fatigue, sleep disturbances, and depression are the most common fibromyalgia symptoms. But you may also experience:

Difficulty concentrating and remembering—sometimes referred to as the "fibro fog"
Dizziness
Pain during and after exercise
Painful menstrual periods
Sensitivity to touch, light, and sound
Stiffness when you wake up or when you've been in one position too long and these are just a few of the symptoms that are experienced. Each of us have and experience different symptoms of the fibromyalgia, so your symptoms may be much different than mine and others but these are some of the factors that have been discovered regarding fibromyalgia. You may find it helpful to keep a diary to record day-to-day pain severity. You'll then be better able to accurately talk about your fibromyalgia symptoms with your doctor, Hope this helps.

It probably is the fibromyalgia, do you suffer with anything else? Possibly mentioned by Heather here.

I suffer a few things that keep my sleep poor and unrefreshing. It could even come down to your bed, bedding, air circulation etc.

Start with the obvious and work on from that. Sleep is so incredibly necessary to feeling well! Gentle hugs and I hooe this helps

I always wake feeling sluggish,slow,sore,and like ive got poison running through my veins.Come good after 3-4 hrs