Why do fibromyalgia and chronic fatigue overlap?

fibromyalgia and chronic fatigue

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Do you ever have those days where you’re certain that if you take a quick nap, you’ll be ready to take on the world? Yeah…that’s not what this article is about. This is about a totally different kind of fatigue. In fact, the word “fatigue” doesn’t seem anywhere close to describing the situation. Chronic “exhaustion” or “depletion” would probably serve us much better. No, we’re talking about fibromyalgia and chronic fatigue. When it comes to fibromyalgia, we’re talking about a kind of fatigue that feels like your whole body is weighted down with cinder blocks. It’s the kind of fatigue that makes even the simplest tasks feel like you’re swimming in mud. In fact, until fibromyalgia came along, you didn’t even know that your energy levels could dip down into the negative numbers.

Chronic fatigue is one of the most incapacitating symptoms associated with fibromyalgia and it effects almost all fibro patients. That’s right, almost all patients experience the fibromyalgia and chronic fatigue overlap. The crazy part is, no matter how tired/fatigued/exhausted you are, people with fibromyalgia tend to sleep very poorly. You’d think that would lead to better sleep, but it doesn’t. Rheumatologist, Dr. Steven Berney, at Temple University Health Systems says that “in fibromyalgia, all treatments are geared toward helping people sleep better. If we can improve their sleep, patients will get better.”

His reasoning is similar to that of Dr. Mary Rose, a clinical psychologist and behavioral sleep specialist at Baylor College of Medicine. She laments that a chronic lack of sleep or even quality, restorative sleep as experienced by fibromyalgia patients affects their overall health and pain. “They feel lousy, exhausted, and their immune system can be damaged.” Dr. Rose adds that sleeping pills are not intended for long-term use. So they aren’t effective when it comes to dealing with chronic fatigue.

Is it the same as chronic fatigue syndrome?

No. Chronic fatigue syndrome (CFS) is primarily characterized by debilitating fatigue. Whereas fibromyalgia is primarily characterized by pain. Researchers explain that 90% of fibromyalgia patients also experience persistent chronic fatigue. However, they add that up to 70% of fibro patients also fulfill the criteria for CFS. Understand that these are two separate conditions, and they don’t simultaneously occur with all fibromyalgia patients. For whatever reason though, there certainly appears to be a connection or “close relationship” between the two conditions.

Why does fibromyalgia keep me awake in the first place?

Despite persistent exhaustion, you still can’t sleep and/or your is very low quality. Researchers are not clear on all the reasons for this because fibromyalgia is such a mysterious condition in general. However, if you suffer from fibro, then you are very likely to have fibromyalgia and sleep apnea. This is a condition wherein you stop breathing for a few breaths or moments. Many with sleep apnea constantly wake up throughout the night because of not breathing. They often have no idea how often they are waking, not to mention that they have stopped breathing.

Another condition common in those with fibromyalgia is restless leg syndrome (RLS). This is a disorder of the nervous system that not only creates the urge to move your legs, but can also be very uncomfortable or painful. You may feel like your legs are itching, your skin is crawling, or as if your legs are on pins and needles. Since it effects sleep so profoundly, RLS is also considered a sleep disorder.

We cannot mention the insomnia or restless sleep that accompanies fibromyalgia without giving a shout-out to a few other triggers, like depression and anxiety. These are regular issues that fibro patients must battle and they are both known to have a link to insomnia and poor sleep.

Of course, this whole thing is a chicken and egg scenario because no one knows which comes first: is it fibromyalgia or the chronic fatigue/insomnia? Does one lead to the other or do they just happen to be related? Don’t worry. They’re still working on it.

What can I do about my fibromyalgia and chronic fatigue?

Remember Dr. Rose? One of her first cautions to her fibro patients is don’t nap! “A lot of patients have circadian rhythm problems. Napping can throw you off. Any sleep during the daytime will be taken from your sleep at night.” She then adds the instructions you’d expect:

  • Reduce stress with yoga, Pilates, meditation, etc.
  • Stretch several times a day, even before you get out of bed each day.
  • Exercise regularly. She especially recommends water exercises for fibromyalgia patients.
  • Pace yourself.

There are other activities and medications you can try, not to mention alternative medical therapies. Have you found something that has been particularly helpful for curbing your chronic fatigue? Please share it with us!


Additional Reading:

WebMD: Living With Fibromyalgia and Chronic Fatigue