The thing that annoys me the most in this journey with chronic pain and fatigue is the way sleep is treated. Please stop ignoring chronic insomnia.
Articles and recommendations either relegate sleep to a sentence recommending you get good sleep, or list low-level sleep hygiene tips like keeping regular bedtimes.
These are all well and good but they’re no where near enough.
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Oh, get good sleep, that’s all?! That is the battle of my life!
Sleep hygiene, why didn’t I think of that?! Oh wait, I have impeccable sleep hygiene.
Any protocol, method or treatment plan that doesn’t involve practical sleep help (and balancing the central nervous system for that matter) is not going to be successful.
You can treat symptoms all you like. But the body needs quality sleep. And it needs to be able to switch on the parasympathetic nervous system.
This is why Doctor Jacob Teitelbaum’s work resonates with me. You can grab his latest book From Fatigued to Fantastic (2021) here.
Sleep is the first and foundational part of his protocol. And, while he does provide sleep hygiene tips and natural sleep aids. He recommends sleep medicine.
I shared about the necessity of good sleep in this post.
In most cases medicine is necessary to combat chronic insomnia
I never reached even the bottom of the normal range of deep sleep until I tried quetiapine.
If a previous doctor had treated me the way my current doctor treated me, I’d be much further along.
When I first met my current doctor, she asked me questions and listened as I told her all of the things I do and have tried to sleep.
She said this level of lack of sleep is a health emergency.
She was the FIRST doctor in about 20 years to take the chronic insomnia seriously and do something about it.
Other doctors have either thrown me on amitriptyline or wanted me to increase the dose. But the reality was they weren’t looking beyond that. It obviously didn’t work for me!
I will always be profoundly thankful for this doctor.
Is everything perfect? No, not even on days I get eight hours of sleep with deep and REM sleep in the normal ranges. But it feels much better.
And just because I have chronic fatigue syndrome doesn’t mean I don’t deserve sleep. I should be doubly entitled!
Most physicians who specialise in fibromyalgia and chronic fatigue syndrome do think sleep is important. All of those with books and research and summits agree. It just hasn’t yet funneled down to general practice.
For my full, current protocol, including the sleep help, see this post.
General Practitioners Need This Information
I took a professional development course on sleep for physicians here in New Zealand and they don’t have many options in their arsenal. We need to change this.
That’s what this work is about. Sharing what’s helped me and research that you can take to start a conversation with your doctor.
In the case of sleep I think the most concise information for both patients and doctors is found in The FibroManual by Dr Liptan. There is a guide for doctors at the back of the book. And a table of sleep medicines that can help with sleep – quetiapine is listed!
In Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis by Dr Myhillĺ there is also a list of sleep medicines for the cases where sleep issues are severe.
If you have chronic insomnia that doesn’t respond to sleep hygiene and supplements I would encourage you to read these books and keep asking. Take the information to your doctor and ask for their help.
If they won’t help, seek an advocate who can help.
Don’t give up.