I just came across this study- Sleep Problems and Risk of Fibromyalgia: Longitudinal Data on an Adult Female Population in Norway- that reminded me of another possible piece of the puzzle regarding my own illness. First, a little about this study and what it found. The study was an attempt to determine whether the poor sleep that many people with Fibromyalgia report is a result of the illness or a contributing factor in developing it. What they found was that "These prospective data indicate a strong dose-dependent association between sleep problems and risk of FM." In other words, not only did having sleep problems earlier in life seem to predispose women to develop Fibromyalgia later, the degree of the sleep issues was relevant. Wow.
Now, for why this is relevant for me. I have had significant sleep problems for as long as I can remember. I mean that- as far back in childhood as I can remember, I had a very hard time waking up in the morning, I did not feel rested in the morning, and I only had bad dreams. Around the age of 8 or 9 I also developed very significant insomnia, often requiring hours to fall asleep each night and often not falling asleep until 3 or 4 AM regardless of when I went to bed or how tired I was. This problem has gotten worse as I've gotten older. It affected my ability to take classes or work in the morning and I often found creative ways of getting around this limitation.
By early adulthood it was such a limitation that I finally persevered in getting a referral to a sleep clinic to determine if I had a sleep disorder. Two overnight sleep studies were performed as well as one daytime nap study. It was clear that my sleep was seriously disordered. The two pieces of information that I was given were that I had tested as having narcolepsy, but they did not give me the diagnosis because they said it meant that I would not be allowed to drive (I am already not able to drive as I am visually impaired). The other thing, that was much more interesting, is that I had what they called "alpha intrusions" meaning that my delta sleep phase was interrupted by bursts of alpha waves.
The delta phase of sleep is the phase of deep sleep in which muscle and tissues are repaired, and at the time that I was researching this I found information suggesting that alpha intrusions (also called alpha-delta sleep) may actually be the cause of the pain in Fibromyalgia. Alpha waves normally occur during wakefulness, and when they occur during the delta sleep phase they disrupt it and keep the repair from happening. This was before my onset of ME/CFS, but I already did have chronic pain and this got me wondering. It seems even more relevant now as the "myalgia" in Fibromyalgia is the same as the "myalgia" in Myalgic Encephalomyelitis. I'm honestly not convinced that they're two distinct illnesses- they seem to be me to be variations on the same theme and this is supported by the evidence that they share underlying causality (this list of the symptoms of FM seems to be essentially the same to me as the symptoms of ME). Here are some links that discuss this connection further:
This article from Health.com discusses the theory that alpha-delta sleep is related to FM. Here is a quote:
"In 1975, pioneering researcher Harvey Moldofsky and his colleagues showed that healthy volunteers who had their sleep repeatedly disturbed developed fibromyalgia-like symptoms, including musculoskeletal aching in specific points around the body.
When asleep, healthy people pass through a cycle of progressively deeper stages of sleep, represented by fast alpha brain waves during the initial stages (indicating a half-awake state), and slow delta waves which are hallmarks of the later stages of deep sleep. But many fibromyalgia sufferers either don't reach deep sleep, or they don't stay there for long. Instead, alpha waves return, indicating to scientists that perhaps part of the brain is improperly active at that time. This phenomenon is known as alpha-delta sleep.
It is now known that crucial things happen to our bodies during deep sleep, including the release of most of the growth hormone that regenerates muscles, repairing all the tiny tears that we accumulate from daily activity.
Many researchers suggest that this lack of restorative sleep could be what's behind aching muscles, as well as the feeling of being totally worn out. (Growth hormone production declines with age, and this is accelerated in the majority of fibromyalgia cases.)"
Effects of Slow Wave Sleep Disruption on Musculoskeletal pain and Fatigue in Middle Aged Women.
This article from The Cleveland Clinic called Brain Basics: Understanding Sleep has some good information about sleep and sleep disorders, including the role of various neurotransmitters
