Sleep
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I have read about a group of healthy volunteers who were sleep deprived and who developed symptoms suggestive of fibromyalgia. (See J Rheumatol. 1999 Jul;26(7):1586-92. Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women. Lentz MJ et al)
So significant sleep deprivation is a likely contributor to CFS or FMS.
Sleep apnoea causes significant sleep deprivation. Try doing the Epworth Sleepiness Scale questionnaire (available online). If you score over 10 the you need to have a home sleep study arranged. I think hospital based sleep studies are not as good because of the artificial sleeping environment.
Another problem is shift work, especially rotating shift work. If you find that you are much worse after doing a week of night shift, then this could point you to a likely major cause of your suboptimal health. Sometimes taking a good dose of melatonin before going to bed dampens down the problems caused by shift work.
Some people have what I call circadian reversal. They go to bed at 4am and get up at 3pm or something similar. They say things like, “I'm not tired until after midnight”. “I just can't go to sleep until the early morning”, “I'm most productive and feel the most alive late at night”. They are often depressed. Usually they eat their main meal late in the evening, like 8 or 9pm and they often don't eat much before then. They may snack after dinner though. They may use their computer, TV or other technology most of the time at night. I guess there's not much else to do when most others are in bed sleeping? In my experience, their mood disturbance cannot be fixed until their circadian rhythm is normalised. Neither can their fatigue. Circadian reversal is, in my opinion, a kind of addiction. Victims are addicted to nightlife. Night is when the human body and mind are designed to sleep. Yep, that is right – night time is sleep time. Because circadian reversal is an addiction, it is hard to convince sufferers to change. In fact, it is pretty much a waste of time trying to help them until they are convinced that it is a problem and are willing to put some serious effort in. Perhaps getting to work on time will be a motivator to help realise that they are living an abnormal and unhealthy existence. Once they are ready to put in effort, you can start a treatment plan. Usually it involves rescheduling of meals, technology use and exercise. It may include various sleep aids such as melatonin, herbal remedies, magnesium, vitamin D and short term use of certain medications.
Other sufferers of sleep deprivation, just can't sleep. They go to bed at a good time, but don't fall off to sleep easily and/or have restless, interrupted sleep. The best thing that I can suggest for such is to go through a checklist of “tips and tricks” for getting a better night's sleep. Here is a list of the ones that I use or recommend:
Move food earlier in the day.
Don't eat big, late dinners.
Watch out for low blood sugars occurring at night (you don't have to eat late to fix low nocturnal blood sugar)
Avoid looking at electronic screens during the one hour before going to bed.
Have a wind-down routine of things to do before bed.
Don't sleep in a damp/cold bed (using an electric blanket to warm and dry your bed is a good idea. Turn off before getting in).
Make sure you have a good air supply. Don't sleep with all windows and doors shut. Fresh air improves sleep quality.
Don't sleep with lights on in your room, unless you really need a night light for safety reason and can't use a torch.
Get treatment for discomforts that effect sleep: pain, itch, indigestion, restless legs, cough, shortness of breath, urinary frequency, etc.
Do not take any pills just before lying down at night as they may get stuck on the way to your stomach and cause heart burn.
Vitamin D, 1000-5000iu about half an hour before bed may assist with sleep.
Magnesium at about 400mg about half an hour before bed may assist with sleep. I have found that some magnesium supplements don't work while others do.
Some herbs taken about half an hour before bed may assist with sleep: valerian, passionflower, chamomile are examples. Some herbs can interact with medications, so check this first with your pharmacist or doctor.
Melatonin in a dose of 1mg to 20mg, depending on the person, may assist with sleep when taken about half an hour before bed. You will need a script in Australia to get melatonin, unless you are able to get it online from overseas. I have not found homeopathic melatonin to work.
Get enough exercise. Gentle evening exercise can be particularly helpful in summer time.
Sometimes electromagnetic frequency (EMF) exposure in your bed can interfere with sleep. Is there a meter board on the other side of the wall behind your head?
Medications for sleep should be avoided if possible except in emergency situations. Some of non chemically addictive ones are antidepressants: Amitryptiline or Nortryptiline or Mirtazipine. Quitiepine is another one that is not chemically addictive.
If you would like to listen to a half hour MP3 talk on sleep, click here.
So significant sleep deprivation is a likely contributor to CFS or FMS.
Sleep apnoea causes significant sleep deprivation. Try doing the Epworth Sleepiness Scale questionnaire (available online). If you score over 10 the you need to have a home sleep study arranged. I think hospital based sleep studies are not as good because of the artificial sleeping environment.
Another problem is shift work, especially rotating shift work. If you find that you are much worse after doing a week of night shift, then this could point you to a likely major cause of your suboptimal health. Sometimes taking a good dose of melatonin before going to bed dampens down the problems caused by shift work.
Some people have what I call circadian reversal. They go to bed at 4am and get up at 3pm or something similar. They say things like, “I'm not tired until after midnight”. “I just can't go to sleep until the early morning”, “I'm most productive and feel the most alive late at night”. They are often depressed. Usually they eat their main meal late in the evening, like 8 or 9pm and they often don't eat much before then. They may snack after dinner though. They may use their computer, TV or other technology most of the time at night. I guess there's not much else to do when most others are in bed sleeping? In my experience, their mood disturbance cannot be fixed until their circadian rhythm is normalised. Neither can their fatigue. Circadian reversal is, in my opinion, a kind of addiction. Victims are addicted to nightlife. Night is when the human body and mind are designed to sleep. Yep, that is right – night time is sleep time. Because circadian reversal is an addiction, it is hard to convince sufferers to change. In fact, it is pretty much a waste of time trying to help them until they are convinced that it is a problem and are willing to put some serious effort in. Perhaps getting to work on time will be a motivator to help realise that they are living an abnormal and unhealthy existence. Once they are ready to put in effort, you can start a treatment plan. Usually it involves rescheduling of meals, technology use and exercise. It may include various sleep aids such as melatonin, herbal remedies, magnesium, vitamin D and short term use of certain medications.
Other sufferers of sleep deprivation, just can't sleep. They go to bed at a good time, but don't fall off to sleep easily and/or have restless, interrupted sleep. The best thing that I can suggest for such is to go through a checklist of “tips and tricks” for getting a better night's sleep. Here is a list of the ones that I use or recommend:
Move food earlier in the day.
Don't eat big, late dinners.
Watch out for low blood sugars occurring at night (you don't have to eat late to fix low nocturnal blood sugar)
Avoid looking at electronic screens during the one hour before going to bed.
Have a wind-down routine of things to do before bed.
Don't sleep in a damp/cold bed (using an electric blanket to warm and dry your bed is a good idea. Turn off before getting in).
Make sure you have a good air supply. Don't sleep with all windows and doors shut. Fresh air improves sleep quality.
Don't sleep with lights on in your room, unless you really need a night light for safety reason and can't use a torch.
Get treatment for discomforts that effect sleep: pain, itch, indigestion, restless legs, cough, shortness of breath, urinary frequency, etc.
Do not take any pills just before lying down at night as they may get stuck on the way to your stomach and cause heart burn.
Vitamin D, 1000-5000iu about half an hour before bed may assist with sleep.
Magnesium at about 400mg about half an hour before bed may assist with sleep. I have found that some magnesium supplements don't work while others do.
Some herbs taken about half an hour before bed may assist with sleep: valerian, passionflower, chamomile are examples. Some herbs can interact with medications, so check this first with your pharmacist or doctor.
Melatonin in a dose of 1mg to 20mg, depending on the person, may assist with sleep when taken about half an hour before bed. You will need a script in Australia to get melatonin, unless you are able to get it online from overseas. I have not found homeopathic melatonin to work.
Get enough exercise. Gentle evening exercise can be particularly helpful in summer time.
Sometimes electromagnetic frequency (EMF) exposure in your bed can interfere with sleep. Is there a meter board on the other side of the wall behind your head?
Medications for sleep should be avoided if possible except in emergency situations. Some of non chemically addictive ones are antidepressants: Amitryptiline or Nortryptiline or Mirtazipine. Quitiepine is another one that is not chemically addictive.
If you would like to listen to a half hour MP3 talk on sleep, click here.
Images and content © D. Bird 2017