Is Poor Sleep Pummeling the Immune System in ME/CFS and Fibromyalgia? A Vicious Circle Examined

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August 31, 2018 - By M G Rana, MD.

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Nap is when our body refreshes itself; no sleep no reconstruction. Poor sleep is the primary symptom many ME/CFS and FM doctors focus on is poor sleep. Poor sleep is identical with both ME/CFS and fibromyalgia. We know it produces fatigue, pain, irritation and mood issues but recent studies suggest that may just be the beginning of the problem.

However, the effects of poor sleep go beyond just feeling awful. It seems that poor sleep can have considerable effects on our immune system, fascinatingly, which are identical to what’s been found in the immune systems of people with ME/CFS and FM. There’s no proof so far that ME/CFS and FM disorders that patients face are caused by poor sleep but scanty sleep can cause at least one immunologically.

The among the most common symptom of fibromyalgia is sleep disturbance, Fibromyalgia is a chronic condition upsetting the spinal cord and brain that causes people to feel tenderness and exhaustion, and affects attentiveness. Actually, besides fatigue, pain, and psychosocial misery, sleep disturbances are a core aspect. It has become gradually clearer in the last few years that treating the connected sleep disturbance makes better the daytime symptoms of fibromyalgia.

Irwin started his assessment on sleep and immunology by noting the “explosion” in our perceptive of the role sleep plays in wellbeing over the past decade. Irwin first demolishes the thought that sleep studies are effectual in diagnosing insomnia or sleep problems except sleep apnea.

A home based sleep actigraph is far more efficient than a one or two-night sleep study, it estimates sleep patterns and circadian rhythms over time and is attached with a sleep diary. In reality, Irwin points out that the diagnosing insomnia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is based exclusively on patient reports of problems going to sleep, maintaining sleep, having non-restorative sleep (common in ME/CFS) and problems with daylight functioning (tiredness, falling asleep, need to doze). (Troubles with daylight functioning are in fact required for diagnosing insomnia.

Widespread pain and sleep

Medical researchers have long sought to clarify the association between sleep disturbance and pain. Until now insufficient is known but a few key findings point out that sleep and pain are intricately connected. For instance, studies of patients undergoing pain after surgery show troubled sleep, decreased rapid eye movement (REM) sleep, and a normalization of sleep as revitalization proceeds.

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Fibromyalgia victims may also acknowledge a change in their patterns of deepest stage of sleep known as slow wave sleep. Researchers deprived a group of healthy middle-aged women of slow wave sleep for a period of three days selectively. Women showed lessened tolerance for pain and increased levels of uneasiness and exhaustion in response, signifying that such sleep disturbance may play a significant role in the progression of fibromyalgia symptoms.

The combination of pain and sleep disturbance is a double-edged sword for people with fibromyalgia: the pain makes sleep more complicated and sleep deficiency exacerbates ache. The excellent news is that decrease in sleep disturbance is generally followed by improvement in pain symptoms. This also highlights the importance of healthy sleep and to find a sleep professional in treating this disease.

The Immune system and sleep

The immune system is infinite and extremely complex and has its own widespread set of regulatory factors, but it itself is synchronized by two other systems, the HPA axis and the sympathetic nervous system. Both are involved in the stress response and both are affected in ME/CFS and FM. The HPA axis is dulled in ME/CFS whereas the the sympathetic nervous system is over-stimulated.

Poor sleep, it turns out activates both system. In the morning in ME/CFS patients the HPA axis is usually believed to be not activated but the sympathetic nervous system (SNS), alternatively, at night whirring away (when it should be peaceful) in both FM and ME/CFS. (Having our “fight or flight” system acting up at night is probably not the best recipe for sleep.) A metabolism is a big issue in ME/CFS right now but guesses what?

Poor sleep also appears to obstruct producing the metabolic assets our immune cells require to hold back infections. We repeatedly think of irritation in negative terms but our immune cells produce pro-inflammatory cytokines and they are essential to fight off intruders. Lessening of a main pro-inflammatory cytokine called IL-6 during reduced sleep obstructs our immune system’s capability to wipe out pathogens.

Whereas pro-inflammatory cytokine’s manufacture at night primes the immune system to hold back pathogens, the day time is a dissimilar story. Increased daytime levels of numerous immune and endothelial factors ((IL-6, TNF) and endothelial markers (E-selectin, sICAM-1) are the cause of chronic sleep deficiency and they are linked with chronic swelling. One study found IL-6 levels actually became flipped in sleep deprived people; they were low at night (thereby hampering their pathogen fighting ability) and high during the day (adding to inflammation. As it repeatedly happens, a woman appears to have gotten the short end of the stick with immune issues and it’s the same with sleep.

Women come out to be more vulnerable than men to swelling that occurs as the result of reduced sleep; it’s women, not men, who come up with increased levels of pro-inflammatory cytokines the day after getting less than eight hours of sleep. (Men show increased levels of pro-inflammatory cytokines after they get less than six hours of sleep). If a sleep deprived person is fighting off an infection the condition may be even bad.

When sleep deprived people were given a toxin (LPS) linked with infections study found skyrocketing levels of damaging pro-inflammatory cytokines. Those damaging cytokines did not show up in healthy people. That recommended that besides the infection they possibly weren’t doing too well at fighting off, sleep-deprived people now had swelling to deal with.