Are You Sleeping?


Do you get enough sleep?

This is what happens to your body if it’s deprived of sleep:

  • You have problems with memory and concentration.
  • You have problems finding the right word.
  • You get irritable – you think so?
  • Neurotransmitters in the brain become altered.
  • You become more susceptible to infection.
  • At its extreme, sleep deprivation can lead to death.

h1sciqsleepwalkingIt seems that no matter how many Ambiens (zolpidem) and Lunestas (eszopiclone) we take, we wake up feeling like shit (sorry – there is just no other word!): feeling hung over and inattentive. So much so that the FDA recently cut recommended doses of Ambien and other drugs that contain zolpidem for fear that their use, even the night before, might impair driving or other activities the next day.

This is because Lunesta and Ambien affect GABA receptors, which are found throughout the brain and are associated with side effects, including thinking disturbances, and deficits in attention and memory, explains Jason Uslaner, lead author of a study published in the April 3 issue of Science Translational Medicine.

A new study funded by Merck (of which Uslaner is director of In Vivo Pharmacology at Merck & Co.) has shown that a new class of sleep medications appears to help people fall asleep without causing grogginess the next day (YES! You did read that correctly!)

These new medications – known as dual orexin receptor antagonists (DORA) – target a more specific region of the brain than the other popular sleep drugs, promoting sleep without affecting cognition.

About 15 years ago, scientists discovered chemical messengers known as orexins, which are released by a relatively small brain region known as the lateral hypothalamus. lateralThis area of the brain releases orexins during the day to keep us awake and lowers levels at night so we can sleep.

The appeal of orexin antagonists, said Dr Michael Thorpy, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City, is that they “target a system that’s more specific for sleep.”

That means, theoretically, fewer side effects and perhaps less of a tendency to be habit-forming, Thorpy explained.

Merck already has one such drug, suvorexant, under review by the FDA.

But with this study, Uslaner and his colleagues investigated a compound called DORA-22, which has the same mechanism of action as suvorexant, to see how it fared alongside Ambien, Lunesta and also diazepam (Valium) in rats and rhesus monkeys.

DORA-22 did not lead to the same mental impairments as the other three drugs. Rhesus monkeys and rats performed just as well on memory and attention tasks shortly after being administered DORA-22 as they did on the placebo.

This is the first time in years that scientists have targeted a totally different receptor in the quest to combat insomnia, said Dr Alexandre Abreu, co-director of the UHealth Sleep Center at the University of Miami Miller School of Medicine.

444-36-cartoonBut many questions remain as even experts note that findings from animal studies do not always hold up in human trials: Do the drugs truly have fewer side effects? Will they be habit-forming? And will they change the quality of sleep in any way?

Those questions will only be answered with more testing and use in humans…(waiting…waiting…waiting…)


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Got Fibro? Now What?

Ok, you have a diagnosis…now what’s going to happen?

ae78c7c2bc0e5642e361bf001c101af9Most likely, your doctor is going to give you medication. There are many different medications used to manage FM, including pain medicines, sleeping pills, and antidepressants.  Some help ease pain. Others boost mood and improve sleep. Working with your doctor will help you find the right medication to add to your multi-faceted comprehensive treatment regimen. That way, you can begin to manage your symptoms effectively…

The first medication doctors will often try is an anti-depressant (this does NOT mean you are necessarily suffering from depression!), which helps relieve pain, fatigue, and sleep problems. Nonetheless, depression is commonly seen in people with FM.

Older anti-depressants, called tricyclics (including Elavil (amitriptyline) and Pamelor (nortriptyline)), have been used for many years to treat FM. They work by raising the levels of chemicals (neurotransmitters) in the brain.

Tricyclic anti-depressants increase levels of serotonin and norepinephrine in the brain. People with chronic pain often have decreased levels of these calming neurotransmitters. Tricyclics can relax painful muscles and heighten the effects of endorphins – the body’s natural painkillers. While these medications are often very effective, the side effects can sometimes make them difficult to take as they may cause drowsiness, dizziness, dry mouth, dry eyes, and constipation.

There are numerous types of anti-depressants and several of them have been shown to help relieve the pain, fatigue, and sleep problems in people with FM.

pillsThe most well-studied anti-depressants for FM include Cymbalta (duloxetine), Savella (milnacipran), and Effexor (venlafaxine). Cymbalta and Savella are specifically FDA-approved to treat FM. There is less medical research to show that Effexor helps FM. Other anti-depressants that have also been studied for FM and may help include Prozac (fluoxetine), Paxil (paroxetine), and Celexa (citalopram).

That’s a lot of different choices to work through and yes, it’s all trial and error to see what works for you. What works for one person with FM may not work for someone else. Different anti-depressants work differently in the body. That’s why you may have to try more than one anti-depressant to find the one that best relieves the pain, fatigue, and sleep difficulties. Your doctor may even want you to try a combination of more than one anti-depressant at a time.

Then, there are different types of pain relievers, sometimes recommended to ease the deep muscle pain and trigger-point pain that comes with FM. The problem is these pain relievers don’t work the same for everyone, either.

article-new_ehow_images_a05_sc_bu_can-nexium_-800x800Non-steroidal anti-inflammatory drugs (NSAIDs), when taken alone, don’t typically work that well for FM. However, when combined with other medications, NSAIDs often do help. NSAIDs are available over the counter and include drugs such as aspirin, ibuprofen, and naproxen. Further, the over-the-counter pain reliever acetaminophen elevates the pain threshold so you perceive less pain. Acetaminophen is relatively free of side effects. But avoid this medication if you have liver disease.

You also need to be careful taking aspirin or other NSAIDs if you have stomach problems. These medications can lead to heartburn, nausea or vomiting, stomach ulcers, and stomach bleeding. Don’t ever take over-the-counter NSAIDs for more than 10 days without checking with your doctor. Taking them for a prolonged period increases the chance of serious side effects.

Sometimes, your doctor will prescribe the muscle relaxant cyclobenzaprine. has proved useful for the treatment of FM. It has proved to be helpful with easing muscle tension and improving sleep. Muscle relaxants work in the brain to relax muscles; but you may experience dry mouth, dizziness, drowsiness, blurred vision, clumsiness, unsteadiness, and change in the colour of your urine. These medications may increase the likelihood of seizures, confusion and hallucinations.

Most recently, Lyrica, originally used to treat seizures, is being used to treat FM. Lyrica affects chemicals in the brain that send pain signals across the nervous system. So it reduces pain and fatigue and improves sleep.

Neurontin (gabapentin) is another anti-seizure medication that has also been shown to improve FM symptoms.

SMFM-278Other medications include pain relievers such as Ultram (tramadol) which is a narcotic-like medication that acts in the brain to affect the sensation of pain. However, it is not as addictive as narcotics.

In addition, doctors may prescribe benzodiazepines such as Ativan (lorazepam), Klonopin (clonazepam), Valium (diazepam), and Xanax (alprazolam) to help relax painful muscles, improve sleep, and relieve symptoms of restless legs syndrome. Benzodiazepines are addictive and must be used with caution on a short-term basis. Taking more than recommended increases the risk of serious side effects, including death.

Powerful narcotic medications, such as Percocet and OxyContin (oxycodone) and Vicodin and Lortab (hydrocodone), should only be considered if all other drugs and alternative therapies have been exhausted and there is no relief.

All of this seems quite daunting which is why you need to surround yourself with a team you trust, which may include doctors, friends and/or family. The most consistent treatment advice that all the experts in FM try to promote is a multi-faceted approach. So, as well as all these medications, you will need to explore a whole range of complementary treatments.

FCKI don’t mean to scare you; in fact, I am trying to help by blogging about research and my experiences with different activities (please explore the site). There is also a directory of other FM bloggers that allows you to find people who are going through the same stuff as you.

Happiness is Having a Scratch for Every Itch

itchy-scratching-110621-02Do you find yourself scratching all the time?

Do you have dry, itchy skin?

Have you developed itchy skin rashes?

Maybe you have back itch?

Or itching ears?

Or maybe you sometimes even feel that horrible itching sensation all over – as if there are ants crawling all over your body…

Itching is just one of a number of symptoms that FM sufferers are lucky enough to suffer. And it’s apparently one of the most common skin problems .

Not only can itching be uncomfortable but it can also be one of those things that prevents you from getting the sleep you need at night. And we have enough trouble as it is!

Why Is Itching Such a Problem When you have Fibromyalgia?

Apparently (and unsurprisingly, when it comes to FM), the medical profession aren’t quite sure! But something they do know, is why this type of itching occurs…

360_backscratcher_0406You see, it’s got to do with how your body interprets your pain signals and it’s otherwise known as a sensory itch. The receptors in the outer layer of your skin are responsible for translating the amount of pressure it receives. These pressures can be translated into pain, for example. But when these receptors come across an unfamiliar pressure, they revert to the ‘default signal’: Itching!

What Can You Do to Ease the Itching Sufferer?

  1. Capsaicin. This topical pain reliever depletes your cells of their pain messengers, essentially forcing them to stop complaining. Tread softly with this one at first, though — it has a burn that’s too intense for some people. (More about capsaicin.)
  2. Ice. Cooling the area can relieve any inflammation that may be putting pressure on the nerve, but most importantly it can deaden the feeling. (Learn to ice properly.)
  3. Pain killers. For the itch itself, acetaminophen is the one that’s most likely to help with nerve pain. Again, if the nerve pain is a result of inflammation, anti-inflammatories may help as well. Some common over-the-counter drugs that contain acetaminophen:
    • img-itchyActifed®
    • Anacin®
    • Benadryl®
    • Cepacol®
    • Contac®
    • Coricindin®
    • Dayquil®
    • Dimetapp®
    • Dristan®
    • Elixir®
    • Excedrin®
    • Feverall®
    • Formula 44®
    • Goody’s® Powders
    • Liquiprin®
    • Midol®
    • Nyquil®
    • Panadol®
    • Robitussin®
    • Saint Joseph® Aspirin-Free
    • Singlet®
    • Sinutab®
    • Sudafed®
    • Theraflu®
    • Triaminic®
    • TYLENOL® Brand Products
    • Vanquish®
    • Vicks®
    • Zicam®
  1. Calming the nervous system. Certain supplements (theanine, rhodiola), medications (Xyrem, Valium, Xanax), acupuncture, and yoga and meditation may all help keep your nerves from being hypersensitive and causing these kinds of sensations.

Talk to your doctor. He/she may be able to help with a treatment or prescription drug.


Valium Vapours

Still very affected by Valium and having lots of trouble keeping my thoughts in one place.

The MRI went well (as a test, not the results – we won’t get them ‘til Monday). I had all the normal problems with them trying to find a vein so I’m a little bruised and sore. I came home afterwards for a nap, thinking all effects from the Valium would disappear. I woke up two hours later feeling much worse, and very, very thirsty.

Oh, and much more foggy than any ‘normal’ fibro fog.


Live(r)ly Noises

Today is MRI (Magnetic resonance imaging) day.

I received a phone call, from the place where it is all happening, telling me that, because the MRI is on my liver, I am not permitted to be sedated via IV, although I am permitted to have an oral sedative. (It seems that I have to be awake enough to breathe in when they tell me.)

An MRI is a scan used for a medical imaging procedure. It uses a magnetic field and radio waves to take pictures inside the body. It is especially helpful to collect pictures of soft tissue such as organs and muscles that don’t show up on x-ray examinations.  It is especially loud, too.

That is why I needed to be sedated – I can’t handle the noise. The term for this is “misophonia,” where sounds can cause severe reactions in people. For me it is the clicking of heels on pavement, a lawn mower, too many people talking at once, humming of a motor or heating system, a baby crying, the car radio when I enter a car…the list is endless. Even more alarming is an unexpected loud noise, such as a motorcycle or firecrackers. I realise that most people can find many of these sounds alarming, but for those with misophonia, the auditory nervous system is in overdrive. I believe that those of us with a hyper-aroused nervous system suffer universally from anxiety and not only do we experience a visceral response to violence, but to anything that startles or is grating to the ears and can raise our anxiety level.

Dr Aage Moller, the neuroscientist at the University of Texas who specializes in the auditory nervous system, believes there is “no known effective treatment”. Dr Moller “believes the condition is hard-wired, like right, or left-handedness, and is probably not an auditory disorder but a “physiological abnormality” that resides in brain structures activated by processed sound”.

My strategy (perhaps the only one) is to fill my day with lovely sounds that bring about joy instead of irrational fear, such as certain music, and listen to people who have soothing voices; but, tomorrow, I’m not going to have a choice.

So, half an hour before this MRI, I have been told to take 5 of my Valium by my GP. I think I’ll take a Panadeine Forte, too, for just in case.

How an MRI works

The MRI scan consists of a table that slides into a large cylinder. Inside the cylinder is a magnet that, when operated, creates a powerful magnetic field.

Soft tissue contains water molecules and the magnetic field acts upon microscopic substances (called protons) found in water. The magnetised protons in the soft tissue send out an echo in response to the MRI scan’s radio waves. A computer then organises these echoes into images.

The MRI scan operator (radiographer) will take cross-sectional images of my body from almost every angle.

And then I wait ‘til Monday to find out if a part of my liver goes the way of my gallbladder.


Miles to go [While] I Sleep

Last night, I went to bed at about 1am. This afternoon, I woke up at 1.45pm. That’s almost 13 hours sleep!


Since I’ve been back from Bali, the hours of sleep I have been having have been increasing steadily.

Now, don’t get jealous – I don’t wake up feeling refreshed; in fact, I think I hurt more than ever. I wake up a number of times and try to move but it hurts so much that I end up falling back to sleep. I really don’t know what I’m doing while I’m asleep but…

That is the way my bed looks before I go to bed…
And this is the way my bed looks when I wake up!

You know how sometimes we say that we wake up feeling like we ran a marathon? Maybe I am!

Every night I take 150mg of Lyrica (I don’t think that helps me sleep as I take the same amount in the morning) and just 2mg of Valium, which is supposed to relax my muscles enough for them to rest while I am sleeping. I guess that’s not working.

So I really have no idea why I’m ‘sleeping’ so much. I do know that I keep putting off my bedtime because I really don’t want to wake up…in pain.