Dreams in Fibromyalgia

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Clinical importance[edit]

It is well established that all or almost all fibromyalgia patients have poor sleep. For the clinician, anything which interferes with sleep should be targeted for correction. Nightmares can disturb sleep in a number of ways including:

  • Loss of sleep as when an hour or more is needed to regain composure to get to get back to sleep.
  • Fear of going to sleep because of fear of having yet another nightmare.
  • Non-restorative sleep if the nightmares occur as a frustrating ongoing ordeal

Lack of adequate studies[edit]

There are few studies on this topic. A large prospective study of healthy subjects is needed who will record their dreams over time. Some will then go on to develop fibromyalgia. Many features should be recorded such as number of nightmares, type of nightmares, dream-like phenomena such as hypnogogic or hypnopompic phenomena, dream pain, post-dream pain, sleep paralysis dreams and the hag phenomena etc. This information could then be used to determine if these factors correlate with the onset, aggravation or improvement in fibromyalgia.

Relation of nightmares in fibromyalgia to co-existing PTSD[edit]

Some cases of fibromyalgia are post traumatic and its onset in these cases is accompanied by the onset of PTSD. In such cases one expects post-traumatic dreams that relive the traumatic event.

Here is one fibromyalgia patient’s description of his dreams which he posted online: “I have 4-6 super vivid dreams that wake me every night. Sometimes it takes an hour to fall back asleep. The dream usually ends with something scary or surprising. My mind can't calm back down afterwards. I read a thread about the paralysis, it's not like that, I can move as soon as I'm conscious. My rheumatologist thinks the lack of sleep is causing my FMS.” (http://www.fibromyalgia-symptoms.org/forums/fibromyalgia_general_discussion/vivid_dreams_lack_of_sleep/)

It is not possible to extrapolate from this man’s dreams to make any general claim about the dreams of other people with fibromyalgia.

Role in chase dreams[edit]

Chase dreams are dreams in which the person is trying to escape from the grave danger of being caught and thereby touched and then harmed. This is one of the most common types of nightmare. It is also a major theme in mythology and folklore. For the Wikipedia article on the wild hunt/wild chase see: https://en.wikipedia.org/wiki/Wild_Hunt.

The Wild Chase.png
The Wild Chase, Franz von Stuck, 1889.
Public domain image.
This image depicts the bloodthirsty demonic God Woton. He is leading a procession of the dead on horseback. He looks like Hitler. (von Stuck was his favourite artist.) He is chasing a victim and will kill him if he catches him.

Some of the author’s fibromyalgia patients had dream pain during nightmares of this kind. Other patients had both dream pain as well as residual post-dream pain after they woke up.

Here is an anecdote of a chase nightmare in a fibromyalgia sufferer that was posted on the internet:

Why do dreams have to seem so real??

“My dreams are so vivid I feel physical pain in them. They aren't always about the same thing though. The first one was horrific, I won't go into too much detail but I was being chased, assaulted and stabbed. And I could feel the immense pain of the knife. Thankfully I eventually woke myself up from it. But had only been asleep for 40 minutes and then stayed up the rest of the night as I was scared I would go back into the nightmare.

I am wondering if it's my meds but I really don't know. I don't sleep often as it is and sometimes when I do I wake up, like tonight, I'm distraught.

I am so desperately tired but I always feel like I am fighting in some way in these dreams that I am exhausted either way.” JT (https://healthunlocked.com/fibromyalgia-action-uk/posts/130226646/why-do-dreams-have-to-seem-so-real)

Further information[edit]

See the Encyclopedia of Touch, Body Sense and Pain, which has an entry for “Nociceptive Hallucinations/Hallucinations of pain".)