What Hurts — and What Helps — Fibro Fog

“Fibro fog refers to common cognitive symptoms that impair day-to-day functioning in individuals with fibromyalgia, including forgetfulness, lapses in concentration, word-finding difficulties, altered thinking, and mental slowing,” says Devika Das, MD, an internal medicine doctor and clinical assistant professor of medicine at Stanford University School of Medicine in Palo Alto, California.

Fibro fog can have a significant impact on work, relationships, and overall well-being. You may find yourself feeling mentally drained long before your day winds down, forgetting appointments or scheduled plans, or losing your train of thought midsentence. Though fibro fog can be draining (and, frankly, aggravating) there are things you can avoid or start to do to manage it.

Common daily practices, some of which you may not even realize you’re doing, can worsen cognitive symptoms. Avoid these habits to keep fibro fog in check:

You Do Too Much or Too Many Things at Once

You Get Poor Quality Sleep

“Sleep plays a key role in memory formation, information processing, and mood regulation,” says Das. “Lack of sleep may also activate inflammatory and stress pathways.”

Even if you think you’re getting adequate z’s, the physical symptoms of fibromyalgia could be keeping you up. “Pain during the night causes micro awakenings — brief interruptions in sleep — that interfere with your ability to progress into (and maintain) deep sleep, which is when most of the brain’s restorative processes occur,” says Ira Chang, MD, a neurologist at HCA HealthONE in Englewood, Colorado.

You Stress Out

It’s a good goal to limit stress wherever possible, because it can trigger fibromyalgia symptoms, including brain fog. “Oftentimes, fibro fog is driven by a combination of things — poor sleep, stress, pain, medications, and additional causes — because they are so closely tied together,” says Das.

Try integrating some of these practices into your routine to feel more clearheaded and focused:

Exercise Regularly

Improve Your Sleep Hygiene

Chang recommends “prioritizing restorative sleep and addressing pain at night.” To do so, avoid caffeine late in the day, try white noise to fall asleep, and leave yourself at least seven to eight hours to sleep regularly. If you still feel foggy or fatigued, chat with your doctor about possible sleep meds or supplements.

Practice Pacing

Pacing is a technique that helps you balance activity and rest in daily life to better manage fibro symptoms. “Break tasks into smaller chunks, and take breaks before becoming exhausted or overwhelmed,” says Chang. You can write breaks into your schedule or set a timer on your phone as a reminder. Scheduling more demanding tasks earlier in the day can also help, she adds.

Try Cognitive Behavioral Therapy

Fibromyalgia fog can be challenging, but there are a things you can do to feel empowered and improve your overall focus and mental clarity. As you test new techniques to reduce brain fog, try not to be too hard on yourself. “Practicing self-compassion and realistic expectations by allowing for breaks, setting boundaries, and giving yourself grace on tough days can reduce stress for mental performance,” says Chang.

• Fibro fog is a common and significant cognitive symptom of fibromyalgia, affecting concentration, daily functioning, and memory.
• Certain habits, such as multitasking, not getting quality sleep, and stressing out, worsen symptoms.
• Targeted strategies such as regular exercise, cognitive behavioral therapy, and relaxation techniques may help reduce stress and improve cognitive resilience over time.