1. FIBROMYALGIA AND CHRONIC PAIN It’s all in your head

2. FIBROMYALGIA Doctors don't know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include: –Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder. –Infections. Some illnesses appear to trigger or aggravate fibromyalgia. –Physical or emotional trauma. Post-traumatic stress disorder has been linked to fibromyalgia.

3. Sleep Disorders Always Accompany Fibromyalgia THE 5 STAGES OF SLEEP

4. Usually sleepers pass through five stages: 1, 2, 3, 4 and REM (rapid eye movement) sleep. These stages progress cyclically from 1 through REM then begin again with stage 1. A complete sleep cycle takes an average of 90 to 110 minutes. The first sleep cycles each night have relatively short REM sleeps and long periods of deep sleep but later in the night, REM periods lengthen and deep sleep time decreases.

5. STAGE 1 Stage 1 is light sleep where you drift in and out of sleep and can be awakened easily. This is considered a transition period between wakefulness and sleep. If you awaken someone in the stage, they might report that they weren't really asleep. During this stage, many people experience sudden muscle contractions preceded by a sensation of falling.

6. STAGE 2 Stage 2 is the second stage of sleep and lasts for approximately 20 minutes. Eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves. Body temperature starts to decrease and heart rate begins to slow.

7. STAGE 3 Deep, slow brain waves known as delta waves begin to emerge during stage 3 sleep. Stage 3 is a transitional period between light sleep and a very deep sleep.

8. STAGE 4 Stage 4 is sometimes referred to as delta sleep because of the slow brain waves known as DELTA WAVES that occur during this time. Stage 4 is a deep sleep that lasts for approximately 30 minutes.

9. REM STAGE OF SLEEP In the REM period, breathing becomes more rapid, irregular and shallow, eyes jerk rapidly and limb muscles are temporarily paralyzed. Brain waves during this stage increase to levels experienced when a person is awake. Also, heart rate increases, blood pressure rises, and the body loses some of the ability to regulate its temperature.

10. REM STAGE OF SLEEP This is the time when most dreams occur, and, if awoken during REM sleep, a person can remember the dreams. Most people experience three to five intervals of REM sleep each night.

11. DELTA SLEEP Stages 3 and 4 are referred to as deep sleep or delta sleep, and it is very difficult to wake someone from them. In deep sleep, there is no eye movement or muscle activity. This is when some children experience bedwetting, sleepwalking or night terrors.

12. DELTA SLEEP Delta Sleep is associated with: –The production and release of Growth Hormone necessary for tissue repair –The production and release of Serotonin which is a neurotransmitter necessary for reducing a persons perception of pain

13. FIBROMYALGIA: Linked to Sleep Disorders In 1975, two Canadian physicians and researchers, Harvey Moldofsky, MD, and Hugh Smythe, MD suspected sleep disorders as a factor in Fibromyalgia. They conducted sleep studies to prove their theory

14. FIBROMYALGIA: Sleep Disorders Using an EEG they measured the brain waves of fibromyalgia patients when they slept The EEG can demonstrate when a person moves in and out of Delta sleep In the study it was found that the patients with Fibromyalgia were unable to go into Stage 4 sleep

15. FIBROMYALGIA: Sleep Disorders Another one of their studies involved awakening healthy people and disrupting their sleep pattern as they entered Delta sleep. They found that the healthy subjects developed fibromyalgia symptoms when their sleep was disturbed, but the symptoms subsided when they were permitted to sleep undisturbed.

16. FIBROMYALGIA: Sleep Disorders They concluded that many of the symptoms associated with fibromyalgia were related to the disrupted sleeping patterns and the inability to enter deep sleep

17. Muscle Abnormalities Linked to Fibromyalgia

18. FIBROMYALGIA: Muscle Abnormalities As we go through the coarse of the day our muscles are constantly experiencing micro traumas. Walking, bending, sitting still for too long creates muscle damage which is repaired each night when we sleep Growth hormone which is important in muscle maintenance and repair, is secreted during Delta Sleep

19. Muscle Abnormalities of Fibromyalgia are Linked to Sleep Disorders Robert Bennett, MD, analyzed the connection between sleep disorders and muscle damage. The research of Dr. Bennett indicates that most fibromyalgia patients have a growth hormone deficiency due to the inability to enter Delta Sleep Recall that Growth Hormone is produced and secreted during Delta Sleep

20. Muscle Abnormalities of Fibromyalgia are Linked to Sleep Disorders Low levels of Growth Hormone due to the inability to enter Delta Sleep results in an inability to repair the micro traumas that occur to the muscles each day This effect is cumulative resulting in the muscle abnormalities and disorders typically observed in Fibromyalgia These abnormalities and disorders are a primary source of pain

21. Muscle Abnormalities of Fibromyalgia are Linked to Sleep Disorders According to this research, the primary goal in addressing the muscle pain of Fibromyalgia should be to re-establish proper sleeping patterns that allow the patient to enter Delta Sleep

22. Fibromyalgia and Pain Perception

23. FIBROMYALGIA: Pain Perception Pain signals are generated by tissue damage in the body The muscle damage of Fibromyalgia creates electrical signals that are transmitted to the brain and perceived as pain The more of these electrical signals that make it to the brain, the more painful the experience

24. FIBROMYALGIA: Pain Perception The human nervous system can modify these electrical signals reducing the number of these signals that make it to the brain. This modification of the signal reduces the patient’s perception of pain This is why some people are more tolerant of pain than others

25. FIBROMYALGIA: Pain Perception In order for the nervous system to do this it needs a neurotransmitter known as Serotonin Serotonin reduces the intensity of pain signals in the nervous system. Serotonin is related to Delta sleep As a person goes into Delta sleep, serotonin is released in the nervous system

26. FIBROMYALGIA: Pain Perception If a person is unable to enter Delta Sleep their levels of Serotonin are reduced resulting in an inability to reduce the pain signals and a heightened perception of pain The disrupted sleeping patterns of a Fibromyalgia patient may result in low levels of Serotonin and may explain why these patients seem to be in constant pain

27. FIBROMYALGIA Tying it all togerther

28. TYING IT ALL TOGETHER Sleep studies have demonstrated that people suffering with Fibromyalgia are unable to enter Delta Sleep Delta Sleep is responsible for the production of: –Human Growth Hormone; and –Serotonin Therefore, the sleep disorders associated with Fibromyalgia result in decreased levels of these substances

29. TYING IT ALL TOGETHER Human Growth Hormone is responsible for repairing the tissues of the body damaged by micro traumas associated with daily activity Without Human Growth Hormone these micro traumas go unrepaired resulting in muscle abnormalities and disorders commonly associated with Fibromyalgia These muscle disorders are a primary source of pain

30. TYING IT ALL TOGETHER Serotonin is a neurotransmitter produced during Delta sleep and responsible for reducing a patient’s perception of pain Low levels of Serotonin caused by the inability to enter Delta Sleep cause a heightened perception of pain such as what we see with Fibromyalgia

31. TREATING FIBROMYALGIA The primary goal in the treatment of Fibromyalgia is to normalize sleeping patterns allowing the patient to enter Delta Sleep

32. INSOMNIA AND NEUROFEEDBACK

33. What is Neurofeedback Used For? Over 40 years of peer reviewed, university based research has demonstrated the efficacy of neurofeedback in addressing many neurological conditions ADHDAnxietyPanic Attacks InsomniaChronic PainBedwetting MigraineFibromyalgiaTBI Tension HeadachePTSDDepression Learning DisordersAutism / Asperger’sTics As well as other conditions

34. TREATING INSOMNIA WITH NEUROFEEDBACK A number of quality studies have been published that show the effectiveness of neurofeedback in not only easing the withdrawal symptoms of sleeping pills, but also normalizing a patients sleep patterns without the use of any medications at all. Neurofeedback research is based upon the principle that insomnia Is connected with what is called hyper-arousal within the brain and central nervous system. This hyper- arousal is bio-electrical, or brainwave based in nature

35. INSOMNIA AND NEUROFEEDBACK Mental states are associated with specific brainwaves Each bo known as arousal l These brainwaves include: –Delta –Theta –Alpha –Beta

36. INSOMNIA AND NEUROFEEDBACK Delta and Theta represent the slowest processing speeds and are associated with a twilight state Alpha represents a slightly faster processing speed and is associated with quiet wakefulness such as when you meditate Beta represents the fastest processing speed and is associated with external focus, thought and concentration

37. THE AROUSAL SPECTRUM A healthy, regulated brain is able to shift easily between arousal states as the demands arise LOW AROUSAL SLOWER PROCESSING Delta and Theta HIGH AROUSAL FASTER PROCESSING Beta IDLE STATE OF THE BRAIN Alpha

38. OPTIMAL ZONE OF PERFORMANCE The Brain has an optimal zone of performance LOW AROUSAL SLOWER PROCESSING HIGH AROUSAL FASTER PROCESSING IDLE STATE OF THE BRAIN Depending on the circumstances and everyday demands, the brain may move toward low arousal or high arousal but a well regulated brain stays within its optimal zone of performance

39. THE DYSREGULATED BRAIN UNDER-AROUSED OVER-AROUSED INHIBITED A dysregulated brain has a tendency to habitually operate from one of the 3 arousal states

40. THE DYSREGULATED BRAIN An individual’s habitual arousal state might be too high or too low to support optimal function UNDER-AROUSED Impulsive Socially Inappropriate Hyper-active Easily Distracted Excessive Speech Disorganized Hyper-emotional OVER-AROUSED Excessive Rationalization Poor Emotional Self Awareness Worry Hyper-vigilant Obsessive Thinking Dislike of Change Restless INHIBITED Victim Mentality Excessive Self Concern Rumination Anger Self Deprecation Agitation Irritability Passive Aggressive

41. THE DYSREGULATED BRAIN An individual’s habitual arousal state might be too high or too low to support optimal function UNDER-AROUSED Excessive Delta and Theta These patients usually present with cognitive impairment, focus and attention issues, ADHD, TBI, dementia, learning disorders OVER-AROUSED Elevated Beta These patients usually present with anxiety, panic attacks, OCD, worry, migraine, tension headache, chronic pain, insomnia INHIBITED Elevated Alpha These patients usually present with symptoms of depression, irritability, lethargy, fibromyalgia, metabolic issues

42. NEUROLOGICAL DYSREGULATION Brainwave Imbalance or Neurological Dysregulation may be caused by: –Variations in brain structure –Drugs –Toxins –Poor Nutrition –Subluxation –Trauma –Stress – both physical and emotional

43. BRAINCORE THERAPY Painless Drugless Non-Invasive And Has No Side Effects

44. How is it Done? All neurofeedback begins by performing a Brain Map

45. The BrainCore Brain Map A Brain Map provides us with the information that is required to perform neurofeedback training

46. THE BRAINCORE BRAIN MAP REPORT The BrainCore Brain Mapping software analyzes thousands of different variables and compares your patient’s brain map with a database of normal brain maps to produce a the Brain Map report

47. THE BRAINCORE BRAIN MAP REPORT The BrainCore Brain Map Report provides the neurofeedback protocols that will be used during the neurofeedback training

48. HOW IS NEUROFEEDBACK DONE Individuals are hooked up to a computer using wires and sensors and the computer reads their brainwaves

49. Information about these brainwaves is displayed on the doctors monitor

50. The software automatically detects when the brainwaves are properly ordered and it feeds that information back to the patient

51. This feedback appears in the form of a game, movie, or sound which signals the patient that the brainwaves are becoming more ordered

52. Rollercoaster Video

53. DVD’s and Movies

54. 54 When you have information on what your brain waves are doing, your brain can use that information to change how it works. THE BIG IDEA:

55. Learning Is Permanent Once we learn something it becomes a permanent part of our behavior. Follow up studies in neurofeedback show that the effects continue for up to 30 years.

56. How Long Does it Take to Get Results? Trainees typically come for 20 sessions of training. Trainees come twice a week or more. Each session is 30-45 minutes long. They typically begin to see changes in about 5 to 8 sessions

57. NEUROFEEDBACK IS BASED IN OVER 40 YEARS OF CLINICAL RESEARCH PROVING IT’S EFFICACY

58. In fact, Dr Frank H. Duffy, a Professor and Pediatric Neurologist at Harvard Medical School, stated that “Neurofeedback should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used”

59. BRAINCORE THERAPY QUESTIONS

60. A GIFT