If you’ve followed this blog for any amount of time, you will know that sleep is a hill I will die on. For me and my children. Sleep is so vital and yet many people with fibromyalgia and ME/CFS will be left with minimal support for sleep.
My history with sleep
Long story short: I’ve experienced trouble sleeping for more than 20 years. I was placed on amitriptyline in my late teens because a locum doctor saw my history of poor sleep. It didn’t help much. But for many years it was all I had.
In 2022 a new doctor, upon hearing my sleep history, told me that level of sleep deprivation is a medical emergency and put me on quetiapine. Since then my sleep has improved. Quetiapine turned out to be the magical last cornerstone for me to sleep.
Sleep hygiene plus low dose Naltrexone plus quetiapine equals magic for me.
New Fitbit Premium tracking sleep
Since I got my brand new Fitbit, I’ve been playing with the extra sleep reporting that comes with Fitbit Premium.
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I got the Fitbit Charge 6 – you can check it out here.
I thought I was sleeping pretty well until I saw the one metric – heart rate variability during sleep.
My heart rate tracks above resting heart rate much of the night. My poor body. I meditate daily, work on perpetuating factors, do breathwork as needed, exercise mindfully etc. so its proof the nervous system is super complex.
Interestingly, there is research showing that higher heart rate overnight indicates increased symptom levels the next day in patients with fibromyalgia. People discussing this research have mostly discussed this in relation to stress. I’d suggest it’s to do with the nervous system and in a much more complex relationship than just stress.
My Sleep Animal
Apparently I’m a parrot right now, which is funny because they describe them as having, “lively attention spans and lots of energy.” (Yes, you can laugh too). But it is very true that I keep a consistent bedtime, get into sound sleep quickly (thanks to Quetiapine) and tend to be in bed for a good amount of time each night. I also tend to get less REM sleep than deep. This doesn’t really tell me much, but it is interesting.
Sleep duration and the skewing of data
Sleep duration accounts for 50% off our sleep score. And I don’t like this. I feel that quality (deep and REM) should make up more than sleep duration. Because duration hasn’t often been my problem, it’s the quality.
The below chart shows that I tend to get into sound sleep quite quickly (because of Quetiapine). And that my sleep duration and deep sleep tends to be at the top of the regular range (and the top two thirds of the optimal range). Though when my deep sleep drops, it drops dramatically. I can have days of 20% and then a day of 8% and boy do I feel that.
My thoughts on using Fitbit Premium for sleep
It can be helpful to hone in on your sleep for a while. But I don’t want to be spending too much time obsessing over sleep. So for now this data is useful. My heart rate and nervous system are important factors. But I can’t do much more than I am doing with my holistic approaches – minimising stress as I can, doing my meditation and breathwork, exercising etc. But as you can likely tell, we can’t directly impact our nervous system and overnight heart rate.
It’s so helpful to know that my heart rate is above resting heart rate for much of the night. This helps me to understand why I have objectively good sleep, but don’t feel it. For this reason the Fitbit Daily Readiness Score doesn’t really give me much good guidance. But the overnight heart rate does. If I can use that to guide my activity and rest the next day, then it will help me finetune my pacing/activities.
