Fibromyalgia

The core of sleep disorders in fibromyalgia is not simple insomnia, but a reduction in the slow-wave sleep (deep sleep) stage. Key elements of sleep hygiene: ① Maintain a regular sleep schedule (the same applies to weekends) ② Take a warm bath 90 minutes before bed (promotes falling asleep through the effect of lowering body temperature) ③ Limit bedroom use to only sleep and sexual activity (blocks stimulus conditioning) ④ Prohibit caffeine within 6 hours of bedtime ⑤ Limit late afternoon naps (within 20 minutes). There is evidence that Cognitive Behavioral Therapy-based sleep therapy (CBT-I) is effective for sleep in fibromyalgia patients. In Korean medicine, insomnia is classified into various differential diagnoses, such as a state where the Yin-Yang balance of the heart and kidneys is disrupted, a state where both heart and spleen energies are deficient, or a state where liver energies are blocked and transformed into heat. Insomnia in fibromyalgia patients mostly follows a pattern where chronic stress causes liver energies to stagnate, leading to heart fire and preventing the onset of sleep, or a pattern where excessive deficiency of qi and blood leaves a lack of a vessel to retain the spirit. At Dongjedang, we calm sympathetic nervous system hyperactivity through acupuncture on the back of the neck and shoulders before bedtime, and improve the sleep structure itself by replenishing the yin and blood of the mind and body with herbal medicine tailored to the patient's constitution. For home practice, we recommend foot baths (40 degrees Celsius for 20 minutes) and massage of acupoints on the crown of the head and around the eyes; consistent practice helps shorten the time it takes to fall asleep.