CFS & Fibromyalgia Related Conditions Fibromyalgia and Sleep Apnea By Adrienne Dellwo Adrienne Dellwo LinkedIn Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. Learn about our editorial process Updated on March 24, 2022 Medically reviewed by Anita C. Chandrasekaran, MD, MPH Medically reviewed by Anita C. Chandrasekaran, MD, MPH LinkedIn Anita Chandrasekaran, MD, MPH, is board-certified in internal medicine and rheumatology and currently works as a rheumatologist at Hartford Healthcare Medical Group in Connecticut. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Overview Diagnosis Symptoms CPAP Other Treatments Coping Fibromyalgia syndrome (FMS) and abnormal sleep breathing commonly go together. Sleep apnea is considered a possible cause or contributing factor for FMS, and FMS may increase your risk of sleep apnea. Any sleep disorder can make FMS symptoms worse, so treating sleep disorders is often a big help in managing the condition.Sleep apnea is one of the more serious sleep disorders because it can lead to life-threatening conditions. Juanmonino / Getty Images Sleep Apnea Overview People with sleep apnea frequently stop breathing while asleep. The need for air can wake them up or bring them out of deep sleep. It's not uncommon for this to happen every few minutes, resulting in poor quality sleep. The most common type of sleep apnea is called obstructive sleep apnea (OSA), in which the airway gets blocked at one of several possible sites. The obstruction can be from excess tissue in the air passage or nasal passages, or a large tongue or tonsils. When the tissues relax during sleep, they block the airway. Obesity increases the risk of OSA. When OSA stops your breathing, your blood oxygen levels drop, your heart beats faster, you get a burst of stress hormones, and your body rouses you to restart breathing. Some people have no idea this is going on, but some awaken with a gasp. OSA carries an increased risk of several other health conditions, some of which are serious and potentially life-threatening. Associated conditions include: Stroke Heart disease or heart failure High blood pressure Heartburn and reflux Diabetes Erectile dysfunction Depression Sudden death Treatment can help lower your risk of developing these problems. Why They Go Together So far, experts don't know why fibromyalgia and OSA go together. It's possible that apnea-caused sleep deprivation contributes to the development of FMS. Diagnosing Sleep Apnea OSA is diagnosed by a polysomnogram or sleep study. These are done at a sleep lab, where you're hooked up to electrodes and monitored throughout the night by a technician. Your healthcare provider may refer you for a sleep study if you report symptoms of sleep apnea or other sleep disorders. Most people with FMS are not given a sleep study, but some practitioners and researchers say sleep studies should be done more often to help identify and treat sleep disorders that exacerbate FMS. Symptoms Some symptoms of FMA and OSA are similar, which can make it harder for you to detect and for your healthcare provider to diagnose. Shared symptoms include: Unrefreshing sleep and excessive daytime sleepinessDifficulty concentratingPersonality changesDepressionInsomnia If you have FMS and notice these symptoms, you should talk to your healthcare provider about the possibility of sleep apnea. Treatment With CPAP The most common treatment for OSA is a machine that provides what's called Continuous Positive Airway Pressure, or CPAP. The continuous pressure keeps your airway from becoming obstructed. Once you're diagnosed with sleep apnea, the healthcare provider will likely send you to a medical-equipment provider, who will fit you with a CPAP mask to wear while you sleep and give you a custom-programmed CPAP machine. Not everyone can tolerate CPAP and FMS can make it harder, especially if you have head, face, or jaw pain. CPAP can also make it harder for some people to fall asleep. My personal experience with CPAP, however, has been very positive. I get better sleep, and I actually find the machine to be somewhat soothing. My daytime fatigue dropped off significantly and my energy level came way up as soon as I started using it. If you find it hard to adjust to CPAP, talk to your healthcare provider or equipment provider to see if they can help you. You may also want to consider other treatment options. Leaving sleep apnea untreated is a poor option, both because of the impact on your FMS and because of the associated serious health risks—remember, some of them can kill you. Other Treatment Options Other sleep apnea treatments include: Losing weight: While it's easier said than done, it can greatly improve the condition. Dental devices: If the jaw position is responsible for the obstruction, wearing a device to bed can be effective. Surgery: This may be the only treatment option for some people who can't tolerate CPAP; however, be sure to take into account that surgery carries serious risks, FMS can slow your recovery rate, and surgery can cause your symptoms to flare up. Coping OSA and FMS can be a tough combination to live with, both because poor sleep makes FMS worse and because FMS makes CPAP especially hard to use. However, with proper treatment from your healthcare provider and diligence on your part, it's possible to feel better and minimize sleep apnea's impact on your life. 16 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Köseoğlu Hİ, İnanır A, Kanbay A, et al. Is there a link between obstructive sleep apnea syndrome and fibromyalgia syndrome?. Turk Thorac J. 2017 May;18(2):40-46. doi:10.5152/TurkThoracJ.2017.16036 National Heart, Lung, and Blood Institute. Sleep Apnea. Marin-Oto M, Vicente EE, Marin JM. Long term management of obstructive sleep apnea and its comorbidities. Multidiscip Respir Med. 2019 Jul;14(1):21. doi:10.1186/s40248-019-0186-3 Kim AM, Keenan BT, Jackson N, et al. Tongue fat and its relationship to obstructive sleep apnea. Sleep. 2014 Oct;37(10):1639-1648. doi:10.5665/sleep.4072 Kritikou I, Basta M, Vgontzas AN, et al. Sleep apnoea and the hypothalamic–pituitary–adrenal axis in men and women: effects of continuous positive airway pressure. Eur Respir J. 2016;47(2):531-540. doi:10.1183/13993003.00319-2015 Kim SD, Cho KS. Obstructive sleep apnea and testosterone deficiency. World J Mens Health. 2019 May;37(1):12-18. doi:10.5534/wjmh.180017 Ou Q, Chen YC, Zhuo SQ, et al. Continuous positive airway pressure treatment reduces mortality in elderly patients with moderate to severe obstructive severe sleep apnea: a cohort study. PLoS One. 2015 Jun;10(6):1-9. doi:10.1371/journal.pone.0127775 Meresh ES, Artin H, Joyce C, et al. Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review. Open Access Rheumatol. 2019 Apr;11(1):103-109. doi:10.2147/OARRR.S196576 Laratta CR, Ayas NT, Povitz M, Pendharkar SR. Diagnosis and treatment of obstructive sleep apnea in adults. CMAJ. 2017;189(48):1-8. doi:10.1503/cmaj.170296 Meresh E, Rao M, Ghattas A, Shah K. Polysomnographic findings in fibromyalgia: a retrospective chart review. 2017 Oct;2(2):126. Choy EHS. The role of sleep in pain and fibromyalgia. Nat Rev Rheumatol. 2015 Apr;11(9):513-520. doi:10.1038/nrrheum.2015.56 Donovan LM, Boeder S, Malhotra A, Patel SR. New developments in the use of positive airway pressure for obstructive sleep apnea. J Thorac Dis. 2015 Aug;7(8):1323-1342. doi:10.3978/j.issn.2072-1439.2015.07.30 Hiensch R, Nandedkar DS, Feinsilver SH. Optimizing CPAP treatment for obstructive sleep apnea. Curr Sleep Medicine Rep. 2016 Apr;2(2):120-125. doi:10.1007/s40675-016-0044-1 Park P, Kim J, Song YJ, et al. Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects. Medicine. 2017 Dec;96(51):1-8. doi:10.1097/MD.0000000000008818 Dodds S, Williams LJ, Roguski A, et al. Mortality and morbidity in obstructive sleep apnoea-hypopnoea syndrome: results from a 30-year prospective cohort study. ERJ Open Res. 2020 Sep;6(3):1-10. doi:10.1183/23120541.00057-2020 Calik M. Treatments for obstructive sleep apnea. J Clin Outcomes Manag. 2016 Apr;34(4):181-192. Additional Reading Eichling PS, Sahni J. Menopause related sleep disorders. J Clin Sleep Med. 2005;1(3):291‐300. Sepici V, Tosun A, Köktürk O. Obstructive sleep apnea syndrome as an uncommon cause of fibromyalgia: a case report. Rheumatol Int. 2007;28(1):69‐71. doi:10.1007/s00296-007-0375-9 Shah MA, Feinberg S, Krishnan E. Sleep-disordered breathing among women with fibromyalgia syndrome. J Clin Rheumatol. 2006;12(6):277‐281. doi:10.1097/01.rhu.0000249771.97221.36. Togo F, Natelson BH, Cherniack NS, FitzGibbons J, Garcon C, Rapoport DM. Sleep structure and sleepiness in chronic fatigue syndrome with or without coexisting fibromyalgia. Arthritis Res Ther. 2008;10(3):R56. doi:10.1186/ar2425 Wahner-Roedler DL, Olson EJ, Narayanan S, et al. Gender-specific differences in a patient population with obstructive sleep apnea-hypopnea syndrome. Gend Med. 2007;4(4):329‐338. doi:10.1016/s1550-8579(07)80062-3 By Adrienne Dellwo Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit