Fibromyalgia Network

Sleep Survey

The October 2001 issue of the Fibromyalgia Network Health Journal featured an article about the various sleep disorders that are prevalent in people with FMS, as well as their treatments. Included in the issue was the survey below. Close to 1,000 patients responded to the survey, producing such intriguing results that we divided the findings into two issues: April 2002 and July 2002 (#57 and #58). You will receive all issues pertaining to the survey when you order our Full Back Pack, which includes a one-year Membership to the Fibromyalgia Network and all available back issues for just $63. Click here to order. The issues are also available for sale individually; call us toll-free at (800) 853-2929 for more information.

Don't miss reading about the most common prescription and non-script aids that patients use to get a better night's sleep. You will also learn what patients do to motivate themselves to get out of bed each morning and how they handle daytime fatigue. In addition, check out the graphs we generated from the survey, showing the relationship between a patient's age, duration of symptoms and specific sleep disorders in people with FMS. All this and more is covered in our sleep survey review (Issues 57 and 58)!

Age (yrs):
Gender: Female Male
Duration of symptoms (yrs):

In the table below, select any sleep disorders that you have. If it has been diagnosed by a doctor, select the last column (Doctor-diagnosed). If you believe you have it, but haven't received a doctor's diagnosis, select the middle column (Self-diagnosed):

Sleep Disorder	Don't have	Self-diagnosed	Doctor-diagnosed
PLMS
RLS
Insomnia
Sleep Apnea
Snoring (you)
Snoring (your partner)
Other (specify below)

If you selected other, please describe here:

Are you on CPAP or oxygen at night?	Yes	No
Have you ever undergone a sleep lab test?	Yes	No

What helps your sleep the most?

A. Prescription sleep medications - list a maximum of two, with the first being the most important:

B. Non-prescription sleep aids - list a maximum of two, with the first being the most important:

(Non-prescription aids may include herbal tea; over-the-counter sleep enhancers such as Kava Kava, Benadryl, melatonin or Valerian; particular food snacks such as crackers, cheese, ice cream and others; glass of milk, hot chocolate or other beverages; sitting in a hot tub; writing in a diary; reading a book; meditation/relaxation therapy; watching TV; or anything else you regularly use to help you fall asleep.)

What time do you typically go to bed at night? AM PM

What time do you get out of bed? AM PM

On average, how long does it take you to fall asleep once you are in bed?

How many times do you typically wake up each night?

What do you think is the other major cause that wakes you?
If you select "Other," please specify in this box...

How many hours on an average do you think you sleep each night?

Do you usually wake up with more pain than you had the night before? Yes No

What do you do to motivate yourself to "get up and go" in the morning?

What do you do to fight daytime fatigue?

Do you nap regularly? Yes No
If yes, how long do you nap? minutes

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