Dying for Some Sleep

At the time, Jackson’s health struggles were written off as mysterious or eccentric. In clinical terms today, his battle with nonrestorative sleep, chronic pain, and fatigue would hopefully be recognized as fibromyalgia—a complex, invisible condition that eludes labs or imaging. I say “hopefully” because more than 15 years after his death, fibromyalgia and other chronic pain syndromes are still overlooked when clinicians fall into the trap of chasing individual symptoms with powerful medications—typically benzodiazepines for sleep and opioids for pain.

Gender assumptions further complicate care. Although fibromyalgia is diagnosed disproportionately in women—80 to 90% of cases—some studies suggest men may account for up to 40%. But until 2016, diagnostic criteria required tender points typical of fibromyalgia in women but uncommon in men. If Jackson were alive today, there’s a chance he might be accurately diagnosed; yet only a chance. The same patient profiling that failed him is still too prevalent.

Medical science now makes it clear that chronic conditions like fibromyalgia are marked by a reinforcing cycle of nonrestorative sleep and persistent pain. Poor sleep amplifies pain sensitivity, and pain in turn further disrupts sleep, locking patients into a debilitating feedback loop. Yet too many clinicians still treat symptoms in isolation—prescribing opioids and other addictive drugs with no established benefit—rather than the constellation of factors that define chronic pain conditions.