Novel Way to Aid Sleep, Relieve Anxiety in Fibromyalgia

Kim Jones, Ph.D., F.N.P., and the team at Oregon Health & Sciences University in Portland, have shown that growth hormone secretion from the brain’s hypothalamus-pituitary system is substantially low in one-third of fibromyalgia patients. Growth hormone is needed in the body for repairing muscle tissues, and inadequate amounts of this hormone could lead to tiny tears in the muscles that eventually generate pain. In fact, a trial to use growth hormone to treat fibromyalgia showed benefit, but this injectable medicine is rarely prescribed because it is costly and not covered by insurance.

The Oregon team tried two relatively inexpensive methods to boost growth hormone production in 165 patients with fibromyalgia during a six-month period.* One method was for patients to take pyridostigmine (PYD), a drug that is used to increase acetylcholine but it also enhances growth hormone secretion. The patients in the PYD group took 60 mg of this medication three times a day (after a dosing up period). The other method was for patients to join a group-exercise program designed for fibromyalgia, because in healthy people exercise is touted as beneficially increasing growth hormone secretion. People in the exercise group met for one hour three times a week.

As it turned out, neither PYD or exercise increased growth hormone secretion in the fibromyalgia patients during the six-month trial. However, PYD was found to significantly improve the patient’s rating of sleep and anxiety.

The authors said they were intrigued by the improvements in sleep and speculate that the PYD may be working to improve the activity in the parasympathetic branch of the autonomic nervous system. The parasympathetic branch is the body’s “rest and digest” control system. It transmits signals mostly through the use of acetylcholine, which is increased by PYD. Many studies have linked reduced parasympathetic activity to sleep disturbances, so taking PYD could be a novel way to improve your sleep.

Only two of the 106 patients assigned to take PYD dropped out of the study because of drug side effects, so in general, PYD is fairly well tolerated. The side effects of PYD include abdominal pain, diarrhea (helpful if you are constipated), and muscle cramping or twitching. PYD is a prescription medication that has been around a long time, is inexpensive, and available as a generic.

* Jones KD, et al. Arthritis & Rheum 58(2):612-22, 2008.