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Most people with Fibromyalgia also have an associated sleep disorder known as alpha- EEG anomaly. In this disorder, the individual's deep sleep periods are interrupted by bouts of waking-type brain activity, resulting in poor sleep. Some people with Fibromyalgia are plagued by other sleep disorders as well, such as sleep apnea, restless leg syndrome etc (see article on Sleep Disorders and FM). Given all these sleep difficulties, people with Fibromyalgia often suffer from chronic fatigue that can range from mild to incapacitating.

What is Sleep?
Waking Brain - Active Brain ----- Perceives and engages with outside world and ensures an organisms survival
Sleeping Brain - Disengagement from the above.

It should be pointed out that the brain itself never sleeps, but is constantly initiating and monitoring all required processes within the body i.e. breathing, kidney function etc. Modern techniques have also shown that the transition into sleep is not gradual, but rather more instantaneous.

Sleep comprises of the following:-
    * Perceptual disengagement
    * Rapid Eye Movement
    * Hypnagogic Imagery
    * Retrograde Amnesia
    * Brain wave changes

The Hypothalamus continually monitors events and keeps the body systems functioning without us being aware.  REM sleep involves internal imagery and placid paralysis of muscles. People normally spend 2hrs in and out of REM sleep throughout the night, but interestingly those with Fibromyalgia may spend many more hours locked in this level, thus having many more vivid dreams as a result, and also waking up unrefreshed in the morning.

What Initiates Sleep?
Sleep is dependent on the internal settings of our bodyclock, which in turn is initiated by Melatonin amongst other hormones/chemicals. There can be a build up of our homeostatic sleep drive which is always active and respondent to sleep deprivation. Therefore, sleep drive and sleep debt are kept in balance as far as possible. You’ve probably already come across the problem where extra hours of unnecessary sleep keeps you awake longer the next day, and if you go without sleep for a period, you eventually spend longer sleeping as a result to “catch up”.

Sleep Debt
Everyone has their required hours of sleep, and sleep debt is cumulative. It can depend on the time of day as to how long it takes to fall asleep, as the body clock will resist sleep at inappropriate times and places. Very sleep deprived people will fall asleep extremely rapidly, usually between 2 and 5 minutes, the normal time being between 10 and 20 minutes. This has actually been used as a test to see how sleep-deprived some people are and is a fairly accurate indicator. Dr Dement states that it is very unhealthy to be in that category who fall asleep very rapidly, as it has been demonstrated that those people are quite unwell, and lacking in many major system requirements to function adequately. Studies have been done into cumulative sleep deprivation showing that fatigue and sleep debt increase over a period. After seven days almost total deprivation, body system function becomes extremely erratic. Students fall asleep much faster than 10yr olds due to sleep deprivation whilst out ‘clubbing’ and so on. Animals are extremely rhythmical with sleep patterns and sleep quite often in their normal environment. If the bio-clock is removed from the body, they sleep continuously with no waking periods worth talking about. The immune system is also involved with alertness levels changing throughout life - everyone is different.


Talk by Dr. William Dement, Portland, Oregon USA
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