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

Implications
It is of concern that three participants described experiences that were indicative of a
sleep disorder that had been undiagnosed, and it became evident that these participants
had not undergone any screening or investigation. Some sleep disorders with an
underlying physical cause, such as sleep apnoea, can be effectively managed using
specific medical treatments once diagnosed (McDaid et al., 2009). The findings of this
study therefore strongly support the European League Against Rheumatism (EULAR)
recommendations, suggesting that patients should be screened for sleep disorders as part
of clinical evaluation. In addition, the recommendations by EULAR suggest that due to
the complexity of FMS, comprehensive evaluations including analysis of sleep quality
are needed to identify individual needs. Optimal treatment of FMS should then be based
on a multidisciplinary approach (including both non-pharmacological and
pharmacological interventions tailored to the identified needs (Perlis, Giles, Bootzin et
al., 1997).
Summary
Sleep difficulties are one of the most challenging symptoms to cope with for patients
with FMS, and poor sleep can exacerbate levels of pain, fatigue, and cognitive
difficulties. This study augmented the findings of the previous two studies in this thesis,
and highlights that people with FMS find awakening in the night in a high state of
arousal, after a short block of sleep, is the most disruptive aspect of their sleep.
Participants expressed a feeling of a lack of control and knowledge of how to manage
their sleep quality and use their medication appropriately. Current information provision
from services appears to be highly diverse. Although half of the participants had been
prescribed hypnotic medication pro re nata (to be taken as and when needed), many
were reluctant to use it due to fears of dependence or side effects the following day. The
majority of participants found the only way to cope with poor sleep was to take naps
during the daytime. Screening for sleep disorders and recommendations on how to
manage sleep disturbance in FMS needs to be included into clinical management
guidelines.
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