Significance of Sleeping/Waking Brain

The significance of the sleeping-waking brain for the understanding
of widespread musculoskeletal pain and fatigue in fibromyalgia
syndrome and allied syndromes.

Joint Bone Spine. 2008 May 2 [Epub ahead of print]

Moldofsky H.

Faculty of Medicine, University of Toronto, Sleep Disorders Clinic of
the Centre for Sleep and Chronobiology, 340 College Street, Suite
580, Toronto, ON MST 3A9, Canada.

PMID: 18456536


The clinical focus of rheumatologists on the widespread pain and
numerous tender points in specific anatomic regions in their patients
who show no evidence for disease pathology has lead to the
characterization of such peripheral symptoms as a specific disorder
of the musculoskeletal system, now commonly known as fibromyalgia.

This rheumatologic diagnostic entity has resulted in relative
inattention to an understanding of their patients' common complaints
of unrefreshing sleep, chronic fatigue and psychological distress.
Experimental evidence from humans and animal studies indicate that
there is an inter-relationship of disturbances in the physiology of
the sleeping-waking brain with the widespread musculoskeletal pain,
chronic fatigue, and psychological distress in patients with hitherto
unexplained pain/fatigue illnesses, e.g., fibromyalgia and chronic
fatigue syndromes.

The emerging knowledge of the dysfunction of the nervous system in
such patients has lead to the study of novel medications that affect
neurotransmitter functions, e.g., pregabalin, serotonin/noradrenaline
compounds and sodium oxybate that are shown to improve many of the
symptoms of such patients.

* * *

A few years ago, someone on the East Coast was working on a theory that the brains of CFS patients, when awake, resemble those of normal people asleep, and that we just had to retrain their brains to wake up.  The therapy being used was playing video games.  I saved the $3000 for the therapy-training sessions and just played Tetris at home.

I can't say whether the difference is that I played Tetris or because I finally found something that helped me sleep better (it was all in the same time frame), but I will say that before I start work each day, I play a little Solitaire.  If the computer keeps telling me "you can't do that" (e.g., put a 7 on a 9), then I know immediately that I am not alert enough to work and I go rest another hour before I try again.  In my business, I have to be alert to much smaller mistakes than putting a 7 on a 9.