Generalized hyper-vigilance and Fibromyalgia


Fibromyalgia is characterized by chronic pain, including an over-sensitivity to non-painful stimuli. Stimuli that are easily ignored, or “tuned out”, by most people; A light touch, a bright light, loud music, and smells are all stimuli that are easily ignored by most people. However, for those of us with Fibromyalgia that’s simply not the case. In addition to chronic pain and sleep issues, Fibromyalgia is characterized by an over-sensitivity to non-painful stimuli. Those of us with Fibromyalgia tend to avoid noisy crowded places and aren’t particular fond of bright lights. This inability to tune out stimuli as well as a heightened perception of stimuli as threatening is generalized hyper-vigilance.

Hyper-vigilance is a heightened awareness of stimuli, activating our flight or fight instinct, leaving us constantly vigilant and in a state of anxiety. All of this can have a negative impact on our overall nervous system.  Generalized Hyper-vigilance is the medical term for the subjective feeling of over-stimulation by stimuli, including light, noise, smell and touch. If you’ve felt that the sheets were just too heavy, the room just too loud, lights too bright, and “OMG what’s that smell?” (that smell that no one else can smell), you’ve experienced generalized hyper-vigilance.   Additional symptoms of generalized hyper-vigilance include irritability, anxiety, and fatigue.

The problem is that our senses are set on high and we notice everything more. Additionally, we are much more likely to perceive these stimuli as threatening or painful, when they are neither.

Fibromyalgia patients are more sensitivity to light, noise and smell

Light sensitivity (or photophobia) is one of many neurological issues that are more commonly reported by those of us with Fibromyalgia.  Additionally, Fibromyalgia patients have been found to have a higher sensitivity to noise indicative of hyper-vigilance. We are also more likely to be sensitive to smells and temperature. These sensitivities often result in worsening of other Fibromyalgia symptoms including pain, headache, and nausea.

There is not a lot of research regarding light sensitivity among those; however, we are more likely to report that we are light sensitive, or photophobic.  Wearing specially tinted lenses, like the Theraspecs lenses that I wear can help reduce the impact of lights, and many find that they are even helpful indoors.  I’ve also found a lot of help by choosing dimmer bulbs and using up lights instead of lamps placed at eye level or above.

While many people find themselves distracted by background noise, it seems that those of us with Fibromyalgia have a much harder time tuning it out. We have a much harder time focusing on a single voice when there are others talking around us, or other background noise. I often find that I pick up little bits of everyone’s conversation but can’t really focus on any single voice. All of that noise can eventually result in a headache or at best it will drain my energy.  Earplugs can help tune out the background noise in public places and make it easier to deal with crowds.Hyperacusis is the medical term for over-sensitivity to certain sound ranges and frequencies. Hyperacusis is also commonly associated with another common symptom of Fibromyalgia – tinnitus, or ringing of the ears.

It would be bad enough if we lived with a single one of these sensitivities, but typically those of us with Fibromyalgia are sensitive to everything. We are hyper-vigilant. This makes it very difficult to handle public environments and increases our anxiety when doing so. This increase in anxiety can add to our sleep issues, as well as increase pain.

Unfortunately, we can’t always avoid public places. So, when you head out remember to take earplugs and sunglasses with you at all times, to help decrease these symptoms of hyper-vigilance. If possible, reduce your time in bright, noisy environments. When you can’t make sure you take time to decompress and rest after experiencing those situations. This can help decrease the effect of stimuli that may cause hyper-vigilance.

Have you noticed an increased sensitivity to various stimuli? Are there certain ones that affect you more than others? What have you found to help?


McDermid, A. J., Rollman, G. B., & McCain, G. A. (1996). Generalized hypervigilance in fibromyalgia: evidence of perceptual amplification. PAIN®66(2-3), 133-144.

Watson, N. F., Buchwald, D., Goldberg, J., Noonan, C., & Ellenbogen, R. G. (2009). Neurologic signs and symptoms in fibromyalgia. Arthritis & Rheumatology60(9), 2839-2844.