Fibro Fog

The loss of mental clarity is twice as common in people with fibromyalgia (some 50 percent to 80 percent report issues) than in those with other rheumatologic conditions, according to a 2016 Clinical and Experimental Rheumatology report.
 
The most common fibro fog complaints include:

• Forgetfulness and problems remembering new information.
• Reduced ability to think quickly and efficiently, especially in distracting environments.
• Difficulty concentrating or feeling alert.
• Difficulty holding conversation or the ability to access stored language information quickly and efficiently.

Scientists aren’t sure how much of fibro fog is caused by the distractions of pain, lack of sleep and other symptoms and how much is a result of the disease itself. Studies of attention, memory and thinking problems in people with fibromyalgia have produced mixed results.

A 2018 controlled trial published in PeerJ that compared working memory in people with fibromyalgia with those of healthy participants found no major differences. The people with fibromyalgia, however, felt strongly that they had significant problems with memory and thinking in their daily life. Study authors think one reason for the disconnect is that taking memory and thinking tests under the controlled conditions of scientific study – and without the distractions of daily life – may not reflect real-world function. 

Although the cause of fibromyalgia fog is still up for debate, many physicians and researchers theorize that it could be related to poor sleep. A 2018 Plos One study comparing people with fibromyalgia, people with depression and healthy individuals found that most cognitive problems reported by those with fibromyalgia were related to poor sleep, which was reported by 99 percent.

“The first thing I ask my patients is how well they’re sleeping,” says Dr. Keenan. “Most will tell me that they’re waking up several times during the night or lying awake for hours. Goal number one becomes getting them to sleep well, which can help them feel sharper and help them better deal with pain.”

Dr. Keenan often tackles sleep issues using a combination of tactics, including medication to help people get the restorative sleep. “Good sleep hygiene also is important,” he says. 
Exercise, which helps improve sleep, has also been shown to improve measures of cognitive function in people with fibromyalgia. 
 
A 2018 study published in Clinical Physiology and Functional Imaging found that people with fibromyalgia who did resistance exercises twice a week for about four months were able to process information more quickly than before the intervention. Exercise also improved sleep quality in people with fibromyalgia in a 2017 American Journal of Physical Medicine & Rehabilitation study of strength training. It found that found nightly sleep disturbances decreased after eight weeks of the workouts. 
 
“I recommend that people with fibromyalgia get as much activity during the day as they can handle, whether it’s walking fifty feet down the street or getting into a warm pool to exercise,” says Dr. Keenan.