Effects of Napping Over Fibromyalgia Symptoms

by M G Rana, MD.

Daytime napping was significantly associated with increased pain, depression, anxiety, fatigue, memory difficulties and sleep problems.

What works for other doesn’t always works for fibromyalgia

Many of us with Fibromyalgia rely on napping to give us a little extra energy to get through the day, but are it possible that those naps may actually be making us feel worse? Personally, I’m one of those that can’t nap. It’s a rare day that I manage to fall asleep during the daytime.

I won’t say it never happens, but it’s not a common occurrence and most of the time when I try to take a nap I can’t. Past studies have indicated that there are beneficial effects of napping for healthy people. Naps less than 30 minutes help replenish lost sleep and provide renewed energy. However, as we all know what works for healthy people doesn’t always work for those with Fibromyalgia.

Experimental studies to see the affect of napping

Frequent daytime napping is associated with greater symptom severity in people with fibromyalgia, confirming the previous notion that those with fibromyalgia nap in order to cope with the condition. Still, there is no evidence that suggests napping is beneficial or detrimental for people with the condition.

Alice Theadom, PhD, of Auckland University of Technology in New Zealand, and colleagues’ surveyed 1,044 adults (92.5% female) diagnosed with fibromyalgia via an online questionnaire to determine how nap frequency and duration correlated with fibromyalgia symptoms.

The researchers found that daytime napping was significantly positively associated with number of comorbidities, level of fatigue, pain, anxiety, depression, sleep problems, and memory difficulties (P<0.01). Daytime napping was also associated with the use of serotonin-norepinephrine reuptake inhibitors or selective serotonin reuptake inhibitors, Pregabalin or Gabapentin, and opioids.

In terms of frequency and duration, those who took frequent daytime naps had more comorbidities, pain, fatigue, memory problems, sleep problems, anxiety, and depression compared to those who napped less frequently or not at all. Those who napped daily for longer than 30 minutes tended to be younger in age, had children living at home, and had higher levels of depression and memory problems compared to those who napped for less than 30 minutes per day.

 

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Day time napping behavior in fibromyalgia sufferers

“It was interesting that in this study, age was not found to be positively associated or predictive of daytime napping behavior in FMS, even with 11.5% of the sample aged over 60 years. Moreover, it was observed that younger adults with FMS napped more frequently and for longer periods of time than older adults; with a higher proportion of younger adults reporting napping due to pain and irritability,” the researchers wrote.

“These findings suggest that napping behavior may be more intrinsically linked to FMS symptoms than other demographic factors; however causality was unable to be determined within this study.”

Is There a Better Time to Nap?

Sleep can be unrefreshing and the fatigue of fibromyalgia can make getting through the day difficult. One way to help you along might be to take a nap, even if you can only manage it on the weekends. But when you wake up from a daytime nap, you want to minimize the sluggish, mentally slow feeling that may greet you (as though your brain has not snapped out of sleep).

So, the question is: should you take the nap in the morning or the afternoon? A study looking at the after effects of a 10 a.m. versus a 3 p.m. nap in healthy people reveals that morning naps may be best for quicker recovery from sleep.* A research team in Ireland purposefully short-changed their study subjects by two hours of sleep the night before so they would be more tired the day of the testing.

Then, they divided the volunteers into three different groups: those allowed a 90-minute morning nap (at 10 a.m.), those allowed a 90-minute afternoon nap (at 3 p.m.), and those who were who were kept awake for the duration of the day (the no-nap group).

Cognitive evaluations and psychomotor vigilant function (i.e., reaction times) were assessed in the two napping groups at both five and 20 minutes after being awakened from their naps. The same tests were done on the control subjects who did not take a nap. The goal of the study was to determine which nap group recovered the fastest from the drowsy effects of sleep.

Conclusion

Healthy subjects in the morning nap group performed equally as well as the no-nap group on the cognitive/vigilant tests. In fact, there was also no difference between this nap group’s test results just five minutes after waking compared to 20 minutes after being awake.

In contrast, the afternoon nap group performed poorly after being awake for five minutes, although they performed as well as the sleepy control subjects on the simple tasks 20 minutes after waking. Looking at the difficulty of the cognitive tests, those that required higher-level functions and greater load on working memory were most affected by the afternoon nap (even after 20 minutes).

In other words, napping subjects actually performed okay on the simple “brainless” cognitive tests. So, if you are not planning to challenge your brain after a nap, you may get by with taking it in the afternoon. Ironically, the afternoon nap folks were a poor judge of their post-nap declines in cognition (i.e., they thought they scored much better than they actually did).

What does this study say about the potential effects of napping on cognitive function? Even if you are tired, you may wake up fewer alerts from an afternoon nap. Instead, it may be best to work through fatigue later in the day with less challenging tasks. But a morning nap may not further impair your abilities.

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Study Reference:

  • Daytime napping associated with increased symptom severity in fibromyalgia syndrome via NCBI NLM

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