Fibromyalgia: Trauma, Sleep disturbances, Night terrors, Sleep walking, Nightmares

“Trauma is so arresting that traumatized people will focus on it compulsively”, Peter Levine

There are so many various kinds of sleep disturbances that it becomes somewhat of a check list to differentiate between them all. Some of us suffer from everyone of them. I began having night terrors when I first started school,age 5, and the nuns told us stories of being responsible for killing Christ because we were born with original sin on our souls. Of course this frightened us and made the entire class cry. We were warned about sin and hell from the first day. I would hyperventilate at night and lose my breath. I was afraid to go to sleep. This was a serious trauma in my childhood. I began sleep walking. It was the time of the polio scare and this was added to the fears. World War ll had not yet ended the year I began school in Montreal and we were afraid our fathers would be sent away and be killed. There was much to be anxious about. My parents were extremely fearful people; my father has recently been diagnosed as a ‘borderline personality disorder’ which added to my lifelong anxiety. And so began my lifetime of night terrors and nightmares. The trauma of my adult life is too lengthy to document here (nor is it necessary) but most of us have experienced traumas of one sort or another, whether major or minor. The women in my book tell stories about their own sleep disturbances based upon their life experiences, so I am not unique in this regard.

Going to bed at night was/is not a peaceful or relaxing experience. Now I usually awake often and the fibro pain is always present. I have tried many relaxing techniques and meditation before going to bed and lately I often try to avoid newspapers and the news. Sleeping time is a challenging process and requires discipline/willpower to make it relaxing and something to look forward to after a tiring day.

Nowadays the minute by minute news is horrifying. Murder, wars, epidemics, economy problems, abuse stories are rampant. Even much of the new music we hear is often grating to our brains and is not pleasant. We are warned hourly about everything that could possibly go wrong in our lives and never taught to relax or look at life joyfully. People with fibromyalgia are those with over- stimulated nervous systems that are constantly bombarded with images of pain and suffering. The amygdala is constantly aroused. Living in this era younger people face many of the same frightening issues those of us in our later years once experienced, only the context has changed : World War l and ll / Iraq and Afghanistan; Polio/ H1N1; Nazi spies/Terrorists. All decades have their demons to frighten and alarm us. What is different now is that we can visually see victims and we are instantly aware of disasters, unlike that of my childhood. How do we train our brains to avoid all those messages we see on TV? We are warned about deadly flu, cancer, strokes, heart disease and yes, even erectile dysfunction, although I must admit the latter does not cause mepersonally to have too much anxiety:-). Every ad sends warnings to our brains (that sensitive little amygdala again) and causes more hypervigilance. It is little wonder that conditioned as we fibro sufferers are to take on these alarms, the night time unconscious brain is even more hyperactive and alarmed. Past or present traumas in our lives incite the nervous system to respond to worry, stimulation and/or excitement.

To prove this point I glanced at today’s newspaper in The Globe and Mailand the front page picture that I first saw was of Khalid Sheik Mohammed under the headlines A TERROR TRIAL IN TROUBLE. Skipping over this I saw another headline about budget cuts. I could feel the anxiety creeping up on me and not wanting to find more horrific examples of death due to H1N1, I was about to put the paper down but I then found the most amazing story about Captain Trevor Greene, who suffered a severe brain injury while serving in the Canadian Armed Forces in Afghanistan. The next words that captured my attention was retraining his brain. “It is neuroplasticity”, he explained in an interview. He said he can “almost feel new pathways forming” (quoted in the article on A14). The article goes on to say “The neuroplastic revolution as some call it, stems from discoveries in the 1960s and 1970s that showed how the brain physically changes as we learn, think and move”. He talks about how it takes a lot of willpower to retrain the brain. But his on-going success story is one of courage and discipline. It was inspiring and I know without doubt, once again, that the former blogs I have written about neuroplasticity are intensely relevant to fibromyalgia. We CAN retrain our brains and form new pathways, particularly with regard to sleep patterns.

I wish though that I had easy answers for those of you who write me about your disturbed sleep patterns. Generally these are the tips I try to follow, hoping to retrain my brain and form new maps: 1) I try to remember that occasionallyI may have a good sleep of at least four or five hours and not awaken once 2) De-catastrophize. I have written elsewhere about our tendency to feed into negativity about our pain, lack of sleep and fatigue and to try not to imagine the worst. This only makes our sleep more troublesome 3) I only go to bed when sleepy. Many of us think that if we go to bed earlier we will have better sleep. That usually isn’t true 4) Try melatonin as it is a natural product and is very helpful for some 5) Try not to nap during the day 6) Have a snack of something that has ‘tryptophan’ in it. Eat a banana or try warm milk 7) Avoid stimulants such as alcohol, which at first may make one sleepy but after it wears off causes stimulation 8 ) Use your bed for only sleeping (or sex), not for reading or watching TV 9) Don’t be a clock watcher (my very worse habit!) 10) Make sure you are not too hot or too cold! If none of these things work don’t be afraid to use a prescribed light medication for a shortperiod of time! Imagine yourself having a restful sleep and follow this positive thought throughout the day. Give your brain a hopeful message! The amygdala, that little part of the brain that affects those of us with fibromyalgia so intensely needs to receive positive messages to let go. As Dr. Levine writes: ” trauma can and must be reformed by working with it internally”. But he also warns that “the solution to vanquishing trauma comes not through confronting it directly, but by working with its reflection, mirrored in our instinctual responses”. We must focus on” internal bodily sensations, rather than attacking the trauma head-on”. A recent pbs.org documentary on sleep/dreams (Nova) has been helpful in understanding the mechanisms of sleep, but did not focus specifically on the difficulties that many of us have with non-restorative sleep.

I am re-reading THE most influential book that I have ever come across regarding healing trauma by Peter Levine, one that I have pictured elsewhere on another blog, Waking the Tiger. He writes about struggling to ignore past trauma or else telling and re-telling (re-traumatizing) and living it over and over. Neither of these approaches heals our past traumas. The amygdala needs soothing, not alarming messages. I wish all therapists would use this book as one which guides their practice. His chapter (12) on hypervigilance is extremely helpful for those of us who recognize how easily we are hyper-aroused (or even more especially for those of us who are in denial regarding the physiological impact of hypervigilance).

Of all the hints I have mentioned we have to train our brains to believe that we do not have to be on guard during the night. We can learn to relax and think of sleep as a safe time to rejuvenate our tired muscles. It takes discipline. We have to remind ourselves that we do occasionally have a good night sleep. Find a comedy show that will bring laughter, listen to soothing music, avoid drama or news on TV and more importantly focus on the bodily sensations that are evoked as we begin to think about the act of sleeping, meditate… ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ

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