Fibromyalgia, CFS and Dysania – Stop the [bed] madness!

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Sleep abnormalities are one of the defining features of both Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM). One of these sleep-related issues is referred to as “morning fog” or a “sleep hangover.” This period of time in the morning can last for up to 1-2 hours after waking, during which individuals report experiencing fatigue, achiness, and mental fogginess. Many times, they are unable to get out of bed. The scientific term for these symptoms is dysania or clinomania which comes from the latin word “clin” meaning bed and “mania” meaning madness. In those with CFS or FM, it can occur in any stage of the illness. Dysania can be very discouraging, frustrating, and even guilt-producing since these patients often feel such a strong desire to stay in bed that they may do so even when it means foregoing responsibilities.

While dysania may be experienced by those with primary depression (or other mood disorders) as well, the root causes are more complicated in those with CFS or FM. Therefore, it is both insensitive and irresponsible for friends, family, and health care providers to dismiss these symptoms as simply a lack of motivation, laziness, or depression. A practitioner who takes this problem seriously will be more likely to treat these chronic illnesses effectively, since proper sleep is not only necessary for overall health and well-being, but also for managing other symptoms related to CFS and FM as well.

Since sleep abnormalities can vary from person to person, the cause of dysania is most likely a combination of factors. Those with CFS and FM may experience difficulty falling or staying asleep, restless leg syndrome, sleep apnea, vivid dreams, periodic leg movements, over-sleeping (more than 10 hours), or not being able to fall asleep until the early morning. These patients almost universally report not feeling rested after a full night’s sleep. Additionally, many of these patients are on medications that could contribute to the morning drowsiness. These include sedating antidepressants, benzodiazepines, hypnotics, and antihistamines.

While sleep medications may be necessary, at least short-term, to help patients achieve more restorative sleep, there are also natural alternatives that may be discussed with your health care provider. Some of the herbs, hormones, and amino acids commonly used to aid relaxation and sleep include chamomile, passion flower, valerian root, melatonin, L-tryptophan, and L-theanine. Practicing good sleep hygiene by establishing habits that support the body’s natural circadian rhythm and removing sleep-sabotaging factors are a few of the ways that patients can help take charge of their own health. Some of these strategies include:

  • Avoiding caffeine, alcohol, and tobacco
  • Planning within your “energy envelope” (not overdoing it during the day)
  • Setting up a quiet, comfortable sleep environment
  • Practicing relaxation techniques before bedtime
  • Reducing stress and worry
  • Limiting daytime napping
  • Exercising/stretching lightly a few hours before bed
  • Developing a bedtime routine
  • Setting your alarm for the same time each day

If these techniques do not improve sleep disturbances and dysania, it may be necessary to investigate further in order to rule out a primary sleep disorder such as sleep apnea or restless leg syndrome. Patients who experience symptoms of dysania should find comfort in the fact that many people, especially those with CFS and FM, have the same struggle getting out of bed in the morning. Talking with your health care provider about strategies to get more restful sleep and minimize side effects from medications can make a world of difference in how you start the day.


1. Chronic Fatigue Syndrome: Diagnosis to Management. Medscape Multispecialty. Available at: Accessed on June 6, 2016.

2. Chronic Fatigue Syndrome and Dysania. Fibromyalgia Natural Relief. Available at:
Accessed on June 6, 2016.

3. Sleep. Treating Chronic Fatigue Syndrome & Fibromyalgia: An Integrated Approach. Available at: Accessed on June 6, 2016.

4. Dysania. Chronic Fatigue Syndrome Treatment Guide, 2nd Edition [excerpt]. Available at: Accessed on June 6, 2016.

About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.