“Fibromyalgia patients have lived with, ‘Well, it’s nothing. We’re giving you nothing, and don’t come back.’ We’re not doing that anymore.” – Dr. Andrew Holman

Living with fibromyalgia, you know what it feels like to live in a body that never really settles down. Even when we’re resting, there’s a background tension that doesn’t fully release. Sleep doesn’t restore us the way it should, stress lingers longer than it seems to for other people, and pain feels louder than it should. It’s exhausting feeling like your nervous system is always braced for impact, even on the days when you’re doing everything “right.”

This constant feeling of being on edge isn’t about mindset or resilience. It’s about how our nervous system has learned to respond over time. When your body stays stuck in fight-or-flight, it interferes with the deep, restorative sleep you need and amplifies pain and sensitivity throughout the day. That’s why getting a deeper understanding of how your nervous system is reacting and supporting it to move away from the fight-or-flight state is often a significant piece of the puzzle in managing your fibro symptoms.

Today, Tami is joined by Dr. Andrew Holman, a board-certified rheumatologist with decades of experience working with fibromyalgia patients. Dr. Holman is the co-founder of Inmedix and has spent years studying how stress biology and autonomic nervous system imbalance affect pain, sleep, and healing.

In this conversation, Tami and Dr. Holman discuss Dr Holman’s clinical observations on fibromyalgia, patterns he noticed over decades treating patients with fibromyalgia, why heart rate variability (HRV) matters, his response to skepticism about fibromyalgia, his perspective on the question of whether fibromyalgia is autoimmune, how sleep deprivation can drive symptoms, why deep restorative sleep matters for pain and cognition, how the autonomic nervous system affects your body, what HRV measures and why it’s a useful window into the stress response, how newer HRV tech aims to separate sympathetic and parasympathetic activity more precisely, using HRV and resting heart rate to spot overexertion and help pace activity, what clinical outcomes can look like when autonomic balance improves, HRV as a potential missing vital sign, the usefulness of HRV data for guiding more individualized treatment decisions, autonomic medicine as a growing frontier, practical steps you can take to better support your nervous system, the critical link between sleep apnea and fibromyalgia, addressing comorbidities that may be contributing to your symptoms, cervical cord compression as a possible contributor to autonomic dysfunction, why tenderness matters in diagnosis, where Dr. Holman’s new HRV tech is in the rollout process, what he sees for the future of fibromyalgia research, and more.

Note: This episode is not meant to be medical advice. Every person and every situation is unique. The information you learn in this episode should be shared and discussed with your own healthcare providers.