Sick and Tired: Understanding and Managing Sleep Difficulties in ...

Theme Two. Inter-relationship between symptoms
When describing how their sleep quality affected them, all participants described the
effects of poor sleep quality on their other FMS symptoms, such as a pain, fatigue and
their ability to manage to those symptoms. Complex interactions between sleep and
symptoms became evident, with participants reporting both direct and indirect effects of
sleep quality on their other symptoms, and a bi-directional effect between sleep and
pain.
Effect of sleep on pain
Eleven participants felt that a poor nights sleep was directly associated with reduced
overall functioning the following day. When asked to describe a typical day living with
FMS one participant described;;
“Today I‟m just exhausted, but I didn‟t sleep, I hardly slept last night so
erm yeah, they (symptoms) completely vary, erm the pain‟s worse today, but
that‟s because I‟m tired, it‟s always worse when I‟m tired.” [011 F59]
Waking up due to the pain
Participants also described that pain affected their sleep quality. Sitting or lying for long
periods of time was perceived to lead to increased pain during the night and participants
often highlighted that they needed to keep changing positions in order to remain
comfortable in bed, or they were restless at night as they were unable to feel
comfortable in one position. Many participants stated that being in pain woke them up
during the night.
“Lack of sleep affects your pain and er, and if you‟re in a lot of pain and
you roll over, the pain will wake you up.” [014 F53]
Reduced ability to manage symptoms
The majority of participants felt that the quality of their sleep was related to feelings of
fatigue and pain. Three participants elaborated that they believed that feeling tired after
a poor nights sleep made it harder to cope the following day, affecting their perceptions
of pain.
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