The Search for Sleep
Sleep is a primary concern for anyone with FMS. Ninety percent of patients awaken multiple times a night, and even if they make it through the night, they rarely sleep deeply enough to feel rejuvenated. Other symptoms may disrupt sleep as well, such as restless legs syndrome (twitchy, cramping legs that cause pain and sleeplessness), irritable bladder, and nocturnal myoclonus (jerky muscles).
Scientists have long known that fibromyalgia involves “disregulated sleep physiology,” or alpha rhythm disturbances occurring during the night and resulting in light, unrefreshing sleep. “If you don’t get eight to nine hours sleep at night, your pain will simply not go away,” says Teitelbaum. “Deep sleep is when you make growth hormones, recharge your batteries, and get rid of pain,” he explains. Teitelbaum’s first line of defense against disturbed sleep is L-theanine (it must be the “L” form). He advises 200 mg at bedtime.
“L-theanine is fantastic,” Shomon says. “With L-theanine, I can sleep without waking up groggy.” Teitelbaum also recommends low-dose melatonin—a maximum of 0.5 mg per night—to encourage a normal sleep cycle. Because sleep is so critical to healing, Teitelbaum may occasionally prescribe sleeping pills, but only as a last resort.
For Cabrera, sleeping and healing went hand-in-hand: “Melatonin really helped give me a deep, long sleep.” After her diagnosis, Cabrera had to quit work and pretty much rested and slept for a year. “I slept 12 to 14 hours per night, plus naps,” she says. “I still use melatonin every night, but now I take a small dose of 0.3 mg.” Cabrera has to watch herself closely, however. “With less than ideal sleep even for one night, some FMS symptoms will return, but I now can reverse them right away,” she says.
A New Sugar for Energy
But no matter how much they rest, people with FMS never seem to have enough energy. That’s not surprising, since research shows FMS sufferers have lower levels of ATP (the body’s cellular energy molecule) along with a lowered ability to make it. But exciting new research with FMS patients shows that supplementing with D-ribose (often just called ribose), the body’s cellular fuel, can help the body replenish ATP.
A natural sugar, ribose occurs in all living cells. “Ribose is the key building block for making energy,” says Teitelbaum. “In fact, the main energy molecules in your body are made of ribose, plus B vitamins and phosphate.” Our bodies acquire ribose through diet—brewer’s yeast has a rich supply—and the body also makes it from glucose in food. This is a slow process, however, that cannot always keep up with the energy lost in daily activities, so it may take several days to restore the lost ATP—and possibly much longer for those who suffer with FMS.
Scientists know that supplemental ribose can reduce muscle pain, stiffness, and exercise fatigue; that people tolerate it well; and that it has no side effects. Armed with this knowledge, Teitelbaum conducted a recent and very promising ribose study in FMS patients. They took 5 grams of ribose three times a day, for an average of 28 days. In just 12 days, 66 percent of those taking ribose had significant improvement in energy, sleep, mental clarity, and pain intensity, with a 44 percent average increase in energy and an overall 30 percent increase in well-being. Although the study is preliminary, with results this positive, look for additional research on ribose soon. Continue reading on next page…