Text Size
Sleep Disorders

If your sleep doesn’t improve despite better sleep hygiene and the use of medications, consider asking your doctor for a referral to a sleep specialist, who can examine you for sleep disorders. Sleep disorders are very common with CFS and FM, affecting a majority of people with CFS and FM, perhaps as many as 80%. Treating them can have a dramatic effect on symptoms.

Two of the most common disorders are sleep apnea and restless legs syndrome.

Sleep Apnea

Sleep apnea, meaning absence of breathing, occurs when a person's airway becomes blocked during sleep and he or she stops breathing. An episode can last from a few seconds to a few minutes.The person then awakens, gasps for air and falls asleep again, usually without being aware of the problem. The cycle can occur many times a night, leaving the person exhausted in the morning.
Apnea is a treatable condition. A common remedy is the use of a CPAP (continuous positive airway pressure) machine. The patient wears a mask through which a compressor delivers a continuous stream of air, keeping the airway open and thus allowing uninterrupted sleep. Use of a CPAP machine can eliminate 90% to 100% of a person’s sleep apnea. Other treatments used for sleep apnea include oral or nasal devices and surgery to enlarge the airway.
Restless Legs Syndrome

Restless legs syndrome (RLS) involves "twitchy limbs," strong unpleasant sensations in the leg muscles that create an urge to move. The problem is often at its worst at night. 

Self-management techniques that may help include reducing consumption of caffeine and other stimulants, establishing a regular sleep pattern, doing exercise that involves the legs, distracting yourself by immersing yourself in activity, using hot or cold baths or showers. Iron deficiency is a major cause of restless legs and should be corrected, as should deficiencies in folate and magnesium.
Several categories of medications may help, including sedatives, drugs affecting dopamine, pain relievers and anticonvulsants. Some of the more commonly used drugs for RLS are the pills Requip and Mirapex, and the patch Neupro. On the other hand, antidepressant medications may trigger RLS. This possibility should be considered if your symptoms began after initiation of mood therapy.

For more on the diagnosis and treatment of sleep apnea and Restless Legs Syndrome, see chapters 11 and 12 in The Mystery of Sleep by Dr. Meir Kryger (Yale University Press, 2017).