FIBROMYALGIA AND
CHRONIC PAIN
It’s all in your head
FIBROMYALGIA
• Doctors don't know what causes fibromyalgia,
but it most likely involves a variety of factors
working together. These may include:
– Genetics. Because fibromyalgia tends to run in
families, there may be certain genetic mutations that
may make you more susceptible to developing the
disorder.
– Infections. Some illnesses appear to trigger or
aggravate fibromyalgia.
– Physical or emotional trauma. Post-traumatic stress
disorder has been linked to fibromyalgia.
Sleep Disorders Always
Accompany Fibromyalgia
THE 5 STAGES OF SLEEP
THE 5 STAGES OF SLEEP
• Usually sleepers pass through five stages: 1, 2, 3,
4 and REM (rapid eye movement) sleep.
• These stages progress cyclically from 1 through
REM then begin again with stage 1.
• A complete sleep cycle takes an average of 90 to
110 minutes.
• The first sleep cycles each night have relatively
short REM sleeps and long periods of deep sleep
but later in the night, REM periods lengthen and
deep sleep time decreases.
STAGE 1
• Stage 1 is light sleep where you drift in and out of
sleep and can be awakened easily.
• This is considered a transition period between
wakefulness and sleep. If you awaken someone
in the stage, they might report that they weren't
really asleep.
• During this stage, many people experience
sudden muscle contractions preceded by a
sensation of falling.
STAGE 2
• Stage 2 is the second stage of sleep and lasts for
approximately 20 minutes.
• Eye movement stops and brain waves become
slower with only an occasional burst of rapid brain
waves.
• Body temperature starts to decrease and heart
rate begins to slow.
STAGE 3
• Deep, slow brain waves known as delta waves
begin to emerge during stage 3 sleep.
• Stage 3 is a transitional period between light
sleep and a very deep sleep.
STAGE 4
• Stage 4 is sometimes referred to as delta sleep
because of the slow brain waves known as
DELTA WAVES that occur during this time.
• Stage 4 is a deep sleep that lasts for
approximately 30 minutes.
REM STAGE OF SLEEP
• In the REM period, breathing becomes more
rapid, irregular and shallow, eyes jerk rapidly and
limb muscles are temporarily paralyzed.
• Brain waves during this stage increase to levels
experienced when a person is awake. Also, heart
rate increases, blood pressure rises, and the
body loses some of the ability to regulate its
temperature.
REM STAGE OF SLEEP
• This is the time when most dreams occur, and, if
awoken during REM sleep, a person can
remember the dreams.
• Most people experience three to five intervals of
REM sleep each night.
DELTA SLEEP
• Stages 3 and 4 are referred to as deep sleep or
delta sleep, and it is very difficult to wake
someone from them.
• In deep sleep, there is no eye movement or
muscle activity.
• This is when some children experience
bedwetting, sleepwalking or night terrors.
DELTA SLEEP
• Delta Sleep is associated with:
– The production and release of Growth Hormone
necessary for tissue repair
– The production and release of Serotonin which is a
neurotransmitter necessary for reducing a persons
perception of pain
FIBROMYALGIA:
Linked to Sleep Disorders
• In 1975, two Canadian physicians and
researchers, Harvey Moldofsky, MD, and Hugh
Smythe, MD suspected sleep disorders as a
factor in Fibromyalgia.
• They conducted sleep studies to prove their
theory
FIBROMYALGIA: Sleep Disorders
• Using an EEG they measured the brain waves of
fibromyalgia patients when they slept
• The EEG can demonstrate when a person moves
in and out of Delta sleep
• In the study it was found that the patients with
Fibromyalgia were unable to go into Stage 4
sleep
FIBROMYALGIA: Sleep Disorders
• Another one of their studies involved awakening
healthy people and disrupting their sleep pattern
as they entered Delta sleep.
• They found that the healthy subjects developed
fibromyalgia symptoms when their sleep was
disturbed, but the symptoms subsided when they
were permitted to sleep undisturbed.
FIBROMYALGIA: Sleep Disorders
• They concluded that many of the symptoms
associated with fibromyalgia were related to the
disrupted sleeping patterns and the inability to
enter deep sleep
Muscle Abnormalities Linked
to Fibromyalgia
FIBROMYALGIA:
Muscle Abnormalities
• As we go through the coarse of the day our
muscles are constantly experiencing micro
traumas.
• Walking, bending, sitting still for too long creates
muscle damage which is repaired each night
when we sleep
• Growth hormone which is important in muscle
maintenance and repair, is secreted during Delta
Sleep
Muscle Abnormalities of Fibromyalgia
are Linked to Sleep Disorders
• Robert Bennett, MD, analyzed the connection
between sleep disorders and muscle damage.
• The research of Dr. Bennett indicates that most
fibromyalgia patients have a growth hormone
deficiency due to the inability to enter Delta Sleep
• Recall that Growth Hormone is produced and
secreted during Delta Sleep
Muscle Abnormalities of Fibromyalgia
are Linked to Sleep Disorders
• Low levels of Growth Hormone due to the inability
to enter Delta Sleep results in an inability to repair
the micro traumas that occur to the muscles each
day
• This effect is cumulative resulting in the muscle
abnormalities and disorders typically observed in
Fibromyalgia
• These abnormalities and disorders are a primary
source of pain
Muscle Abnormalities of Fibromyalgia
are Linked to Sleep Disorders
• According to this research, the primary goal in
addressing the muscle pain of Fibromyalgia
should be to re-establish proper sleeping patterns
that allow the patient to enter Delta Sleep
Fibromyalgia and Pain
Perception
FIBROMYALGIA:
Pain Perception
• Pain signals are generated by tissue damage in
the body
• The muscle damage of Fibromyalgia creates
electrical signals that are transmitted to the brain
and perceived as pain
• The more of these electrical signals that make it to
the brain, the more painful the experience
FIBROMYALGIA:
Pain Perception
• The human nervous system can modify these
electrical signals reducing the number of these
signals that make it to the brain.
• This modification of the signal reduces the
patient’s perception of pain
• This is why some people are more tolerant of pain
than others
FIBROMYALGIA:
Pain Perception
• In order for the nervous system to do this it needs
a neurotransmitter known as Serotonin
• Serotonin reduces the intensity of pain signals in
the nervous system.
• Serotonin is related to Delta sleep
• As a person goes into Delta sleep, serotonin is
released in the nervous system
FIBROMYALGIA:
Pain Perception
• If a person is unable to enter Delta Sleep their
levels of Serotonin are reduced resulting in an
inability to reduce the pain signals and a
heightened perception of pain
• The disrupted sleeping patterns of a Fibromyalgia
patient may result in low levels of Serotonin and
may explain why these patients seem to be in
constant pain
FIBROMYALGIA
Tying it all togerther
TYING IT ALL TOGETHER
• Sleep studies have demonstrated that people
suffering with Fibromyalgia are unable to enter
Delta Sleep
• Delta Sleep is responsible for the production of:
– Human Growth Hormone; and
– Serotonin
• Therefore, the sleep disorders associated with
Fibromyalgia result in decreased levels of these
substances
TYING IT ALL TOGETHER
• Human Growth Hormone is responsible for
repairing the tissues of the body damaged by
micro traumas associated with daily activity
• Without Human Growth Hormone these micro
traumas go unrepaired resulting in muscle
abnormalities and disorders commonly
associated with Fibromyalgia
• These muscle disorders are a primary source of
pain
TYING IT ALL TOGETHER
• Serotonin is a neurotransmitter produced during
Delta sleep and responsible for reducing a
patient’s perception of pain
• Low levels of Serotonin caused by the inability to
enter Delta Sleep cause a heightened perception
of pain such as what we see with Fibromyalgia
TREATING FIBROMYALGIA
The primary goal in the
treatment of Fibromyalgia is
to normalize sleeping
patterns allowing the patient
to enter Delta Sleep
FIBROMYALGIA AND NEUROFEEDBACK
WITH BRAINCORE THERAPY
• Neurological Dysregulation of brain waves may
be the cause of the disrupted Delta sleep as well
as the abnormal levels of serotonin and human
growth hormone
• Neurofeedback teaches the patient how to
regulate their brainwaves resulting in a more
balanced pattern
RECENT RESEARCH
• Neurofeedback in fibromyalgia syndrome.
Kayiran S, Dursun E, Ermutlu N, Dursun N,
Karamürsel
• Kocaeli University, Faculty of Medicine,
Department of Physical Medicine and
Rehabilitation, Kocaeli, Turkey.
Neurofeedback in fibromyalgia
syndrome
• “We applied a NFB protocol on three patients with
Fibromyalgia Syndrome (FMS).
• Most of the symptoms were decreased after ten
sessions.
• There was also improvement in all of the scales
after the treatment.”
NEUROLOGICAL
DYSREGULATION
Abnormal Brain Wave
Patterns
NEUROLOGICAL
DYSREGULATION
• Brainwave Imbalance
• May be caused by:
– Variations in brain structure
– Drugs
– Toxins
– Poor Nutrition
– Subluxation
– Trauma
– Stress – both physical and emotional
NEUROLOGICAL REGULATION
• The ability of the brain to regulate itself
• Mental states are associated with specific brainwaves
• These brainwaves include:
– Delta
– Theta
– Alpha
– Beta
DELTA BRAIN WAVES
• Produced during deep sleep
• Associated with the release of
Human Growth Hormone and
Serotonin
NEUROFEEDBACK
• Neurological Dysregulation of brainwaves may
result in disruption of the sleep cycle making it
hard for the person to attain the Delta state.
• Neurofeedback is directed at teaching the patient
how to regulate and balance their own brainwaves
BRAINCORE THERAPY
THE BRAINCORE APPROACH
•
•
•
•
Painless
Drugless
Non-Invasive
And Has No Side
Effects
THE BRAINCORE EVALUATION
A Window To the Brain
• The EEG evaluation begins
by placing surface sensors at
specific sites on the scalp
• These sensors detect brain
waves and display them on
the computer screen
THE BRAINCORE EVALUATION
A Window To the Brain
• During the course of the next 10
minutes the patient is asked to
perform several tasks while the
BRAINCORE software monitors
the brainwaves
• A report is generated
demonstrating imbalances
associated with Insomnia
THE BRAINCORE TRAINING
• Based on the patient history and the
BRAINCORE EEG Evaluation results, a
customized training program is designed for
the patient
• The training program is different for each
individual case but typically it involves either
training the patient to produce more of a
certain brainwave or less of a certain
brainwave
THE BRAINCORE TRAINING
• During the training session the patient is
connected to the EEG using the surface
sensors and the patient’s brainwaves are
displayed on the computer
• On a separate monitor the patient is
watching a movie that is being controlled by
the patient’s own brainwaves
THE BRAINCORE TRAINING
• The movie will only play if the patient’s brain
is producing the desired brainwave
• During the course of 20 training sessions,
the patient’s brain learns how to produce the
desired brainwave
• This new ability is associated with the
alleviation of the insomnia symptoms
THE BRAINCORE TRAINING
• The best part is that the changes
experienced by the patient are permanent!
• It has been demonstrated that after 20 or
more BRAINCORE training sessions, the
brain actually remodels itself – a process
known as Neuroplasticity
BRAINCORE THERAPY
QUESTIONS
A GIFT