Living with Unrefreshing Sleep in Fibromyalgia & Chronic Fatigue Syndrome

A Typical Day

Unrefreshing Sleep
Unrefreshing sleep is common in fibromyalgia & chronic fatigue syndrome.. Mark Douet/Getty Images

What is Unrefreshing Sleep Like?

Unrefreshing sleep is a common symptom of both fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS). Basically, it means that, even if we get plenty of sleep, we still don't feel refreshed.

This symptom can have a major impact on your life. It not only makes you tired, but means low energy levels throughout the day. It can also exacerbate other symptoms, including pain and cognitive dysfunction (brain fog or fibro fog.)

Below is an example, from my own life, of how it feels to go through a day with unrefreshing sleep and the resulting symptoms.

Morning Comes … Too Soon

A strange noise intrudes into the middle of a dream. It takes me a while to realize it's not part of the dream – it's something important. The phone? No, the alarm clock.

But it feels like I've barely been to sleep, I think, as I flail my arm around and eventually hit the snooze button. After three (or is it four?) more snooze alarms, I know I have to get out of bed.

I force myself to push the covers back and sit up. I'm nauseous, weak and shaky. Every cell of my body screams at me to LAY BACK DOWN, but instead I stand up. My muscles, still tired from yesterday, ache in protest.

I get my kids out of bed and lay down on the couch, so I'm close if they need anything as they get ready for school. I doze on and off, hearing the shower, the clanking of plates in the kitchen, then the TV playing some action cartoon.

I'd like to be up getting them breakfast, chatting with them while they eat, etc. Some mornings I can manage that. This is not one of them.

The alarm on my cell phone goes off – it's set for the time they need to leave, in case I'm too asleep to keep an eye on the time. Today, it's a good thing, because I was dreaming again.

With a stabbing pain in my gut, I make sure the kids have got everything they need and usher them out the door.

Now it's decision time: do I go back to bed or try to stay up and be productive? I know my physical energy is low. I evaluate my mental energy and decide that, with some caffeine and a little time, I might be okay. The stabbing pain has receded to what, for me, is a tolerable level.

I eat a small breakfast, then watch TV while drinking some tea. It's not long until I decide I need to lay down – even sitting up is too much exertion right now. Plus I'm getting a headache.

Once I lay down, I'm back to sleep in a matter of minutes.


My husband calls on his lunch hour and wakes me up. I feel guilty for sleeping so much while he's working.

I finish my tea and decide I have enough energy to do a little something. I put a load of laundry in the washing machine, and then unload the top rack of the dishwasher before my muscles feel fatigued.

Mentally, I might be able to deal with the world now.

I sit down at the computer and look at my to-do list. I have some writing to do. Bills need paid. Grocery shopping? Maybe later. Maybe tomorrow.

I get a little bit of writing done, but it's like pulling teeth. I decide to edit it later and move on to something else.

I gather and sort the bills, then set them aside for my husband. (With my impaired math skills from fibro fog, we don't dare trust me with them!) I transfer clothes from the washer to the dryer and hope I have the energy to hang them up when they're done.

I should eat, but my brain feels like it's packed in cotton and lunch doesn't even occur to me. I take my laptop to the couch and do stuff that doesn't take much thought while I watch TV. The computer is basically to ensure that I don't fall back to sleep. I don't really hear the TV while I'm reading emails and Facebook posts, so I have no idea what's going on in the show.


My husband and the kids are home and I realize I haven't even thought about dinner. Then my stomach growls and reminds me that I haven't 9 a.m.

Fortunately, I do have some thawed meat in the fridge. I get that in the oven and chop up some lettuce for a salad. I eat a salad right away because I'm too hungry to wait.

I get ambitious and decide to finish unloading the dishwasher. After about the third time I bend over, dizziness hits. My husband walks in to see me staggering with a few plates in my hand. He puts his hands on my shoulders to steady me.

"Do you need me to take over?" he asks.

I nod vacantly and lay down on the couch, grateful that he understands and is willing to help out when I need it.

Before long, dinner is ready and I drag myself to the table to eat. Then, it's back to the couch to watch a show with my husband.

Maybe it's the food. Maybe it's the company. Maybe it's that I've finally rested enough for my body to function. I begin to feel awake and alert. For me, anyway.


Everyone else goes to bed, but I'm feeling pretty good. My back hurts too much to hang clothes, so I edit what I wrote earlier, do a little more work, and then decide I should relax and wind down so I can sleep.

Ah, insomnia. After several hours of TV and reading, I finally feel tired and head to bed. I've got six hours before I need to get the kids up and start this all over again – not too bad. Maybe tomorrow, I'll be able to get more done.

Learn More:

While the results of unrefreshing sleep are similar whether you have FMS or ME/CFS, the mechanisms behind this symptom appear to be quite different. You can learn more about them here:

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