Sleep and Fibromyalgia

Fibromyalgia is a condition that has been misunderstood, underestimated, miscategorized and even dispelled as not real at all for decades. With new and greater understanding, both from the medical profession and people in general, fibromyalgia is now being taken more seriously, as are some of the things that come along with it, including disturbed sleep.

What is Fibromyalgia?

Of all common chronic conditions, fibromyalgia is, as we mentioned, one of the most misunderstood. And even these days, when more is being done to help and treat those diagnosed with fibromyalgia, some have to struggle for years to find explanations for their symptoms in the face of dealing with less informed doctors who still dismiss the condition as something that is ‘all in their head’.

As research into the disease increases, more theories are emerging, however. One of the most popular is that the disease is the result of a ‘disconnect’ between the brain and the spinal cord that causes pain signals to be processed incorrectly, resulting in chronic pain that seemingly has no physical explanation.

What are the Symptoms of Fibromyalgia?

According to information from the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the NIH, fibromyalgia is classified as a chronic disease that causes, among other things, long term, widespread pain, joint stiffness, cognitive dysfunction, sleep problems and daytime fatigue.

Symptoms of Fibromyalgia
Fibromyalgia has many symptoms that tend to vary from person to person.

However, these are just some of the symptoms associated with the condition. Some people also report digestive problems, confusion, memory loss, muscle weakness and more.

How Is Fibromyalgia Diagnosed?

Unlike some other chronic conditions, fibromyalgia cannot be diagnosed via blood tests or biopsies. It can’t be ‘seen’ in x-rays or cat scans either. Instead, doctors must link together a set of symptoms, follow current guidelines and wisdom and rule out any other possible underlying causes.

Current diagnostic guidelines for fibromyalgia as laid out by the American College of Rheumatology include – but are not limited to, the following.

  • Widespread, sometimes constant pain that is present for three months or more lasting at least three months
  • Muscle pain that feels like burning
  • Digestive problems
  • Persistent daytime fatigue, with or without poor sleep
  • Difficulty ‘thinking’ or remembering simple, previously learned concepts
  • No other underlying conditions that could be causing the symptoms

Treating Fibromyalgia

As hard as it is to diagnose, fibromyalgia can be just as hard to treat. There is no known cure at this time, and because the condition can often occur alongside others, including IBS and Lyme Disease treatment plans need to be individualized and adjusted as needed.

However, some of the most common treatments include:

  • Traditional pain management
  • CBT (cognitive-behavioral therapy)
  • Alternative treatments including CBD and medical marijuana
  • Sleep hygiene therapies
  • Basic lifestyle and diet changes
  • Yoga, Pilates and other low impact exercise programs

Who Gets Fibromyalgia?

Woman lying on her stomach sleeping on white crisp sheets
It is the most common musculoskeletal condition after osteoarthritis and more common in women aged 25-60

In the ‘dark ages’ before the condition was better accepted it was thought that fibromyalgia was mainly a complaint associated with middle-aged women. However, in recent years most diagnoses have been made in patients of both sexes in their 20s and 30s.

Current accepted research and anecdotal evidence seems to suggest that all the following are likely to be risk factors for developing fibromyalgia:

  • Being female
  • Having suffered a severe infection in the past
  • Having been diagnosed arthritis
  • Having been diagnosed with a mood disorder such as depression or anxiety
  • Living an inactive lifestyle which does not include enough regular exercise
  • Having been diagnosed with PTSD
  • Having experienced emotional or physical abuse
  • Having other family members with the condition.

Fibromyalgia and Sleep

One of the most common symptoms of fibromyalgia is chronic daytime fatigue. This can even occur after a person has enjoyed the recommended eight hours of sleep at night, but, without significant lifestyle changes, most fibromyalgia patients suffer from insomnia and broken, or poor-quality sleep.

Some medical professionals refer to fibromyalgia as a ‘fight or flight’ based condition, and that does explain the difficulty that many patients have sleeping. Researchers have found that fibromyalgia causes patients to remain in a ‘hypervigilant state’ much of the time, including at bedtime, leading to trouble getting to sleep, and staying that way.

The effects of a lack of sleep alone are enough to cause significant health problems by itself, including long term effects like a higher risk of developing heart disease and high blood pressure as well as causing an increase in difficulty in maintaining a healthy weight. Add this to the already difficult to live with everyday health problems fibromyalgia patients commonly suffer from and you have a difficult health situation indeed, which is why one of the most commonly repeated pieces of advice given to fibromyalgia patients of all ages is that they prioritize sleep.

Also Read: Why Do We Sleep and Why Need It?

Will Getting More Sleep Reduce Fibromyalgia Pain?

Given that fibromyalgia patients are advised to prioritize sleep the obvious question you might ask is will getting more sleep help reduce the chronic pain that is such a big part of the condition?

Like so much else that is associated with the condition, there’s no definitive answer yet, but emerging studies are finding links between an increased amount of good sleep and a decreased amount of fibromyalgia pain.

One University of Washington study, conducted with middle-aged women, half of whom were diagnosed with fibromyalgia and half who identified as ‘healthy’ actually found that disturbed sleep decreased the pain tolerance for all participants, underscoring the importance of good sleep for everyone, not just those with a medical condition.

In the patients with diagnosed fibromyalgia as expected, the results were magnified. But there have yet to be many verified research studies that can conclusively prove that increased sleep leads to decreased fibromyalgia pain. However, significant amounts of anecdotal evidence from patients themselves certainly seems to more than suggest it.

Improving Sleep When You Have Fibromyalgia

Woman struggling to sleep because of pain
The severe pain of this condition also means that it is difficult to sleep.

It is one thing to be told to prioritize sleep if you suffer from fibromyalgia, but it is quite another to be able to do that. The one thing that has been very well-documented is that any pain can very easily disturb sleep, something most people discover for themselves at one point or another in their lives.

Therefore, if you suffer from chronic pain, like that caused by fibromyalgia, and it is difficult to manage in general, getting a better night’s sleep in the hopes of being able to experience less pain is hard, and something of a vicious circle.

More pain= less sleep. Less sleep may equal more pain.

While many people with fibromyalgia often turn to sleep medications doctors are increasingly questioning the wisdom of doing so. All of these medications, including OTC versions, carry a significant addiction risk and have unpleasant side effects of their own, including increased daytime drowsiness, not something that fibromyalgia patients want as that is something they are usually already trying to combat as a result of their condition.

What might be effective instead?

According to experts and to fibromyalgia the following tips may be very helpful for some, in addition, of course, to discussing the issue with your doctor.

Sleep in the Right Bed on the Right Mattress

The bed – and its mattress – slept on at night makes a difference to anyone’s sleep. For fibromyalgia patients trying to get an adequate (at least) night’s sleep on a bed that is not suited to their needs can prove almost impossible.

What makes a ‘great’ choice for you as a fibromyalgia patient will vary, but adequate support is very important, although lying flat on a very hard mattress is probably not the answer.

Often a memory foam bed, which offers support but reduces motion transfer is a good option, but as that can become rather hot, a version that boasts a cooling mechanism may be more suitable.

The good news is that both bed and mattress technology is moving at a fast pace, as more and more people realize what a significant effect sleep has on health in general. Taking the time to find the right bed for you is something that many fibromyalgia patients report makes a big difference to both your pain levels and general daily quality of life. You may need to be willing to spend a little more, but it’s an investment in your health and well-being that will offer a great return on your investment.

Stay Cool While You Are Sleeping

In addition to choosing a cooling mattress, to prevent overheating from keeping you awake try opting for all  cotton, silk or linen bedsheets – which are naturally very cooling, and looser fitting cotton nightclothes. You should also ensure that the bedding you choose is not too constricting either.

Many people with fibromyalgia also suffer from Restless Leg Syndrome – RLS – and getting your legs tangled up in over restrictive bedding is certainly likely to wake you up!

The temperature in the room can also be very important. A room that is too hot, even in the winter months, is rarely conducive to a good night’s sleep for anyone, let alone someone who suffers from a health condition that already makes it hard for them to sleep.

Invest in a weighted blanket

Many fibromyalgia patients have found relief through myofascial release, a therapy that involves gentle pressure over trigger-points, tender point sides, and even the whole body. Weighted blankets can recreate this steady pressure, so may provide easy pain relief for those suffering from fibromyalgia.

According to sleep medicine experts from the prestigious Cleveland Clinic the ideal bedroom temperature is between 67 and 69F (19-20.5C). Or, as they put it; “think of the bedroom as your “cave” — it should be cool, dark and quiet to enhance your sleep.”

If your room is too hot or too cold it impacts the quality, as well as the quantity of your sleep, as you are most likely to be woken form REM sleep by temperature issues. REM sleep is the stage at which you ‘dream’, and according to the National Sleep Foundation, good REM sleep has been found to improve both mood and memory, while a lack of it is believed to damage both physical and emotional health in most adults, so getting enough is a must for everyone, but especially if your suffer from fibromyalgia.

Getting More Appropriate Exercise

Most fibromyalgia patients are told that they should ensure they get enough exercise, but that can be hard, as their pain often limits what they can achieve. Yoga, and the similar discipline of Pilates are both however exercise options that many sufferers find they can not only manage but that are also very effective in helping reduce their symptoms and relieve insomnia.

Exercise has been found to help relieve insomnia and poor sleep in many people, but only when it is undertaken at the right time. Any sessions should be completed at least three hours before bedtime, as exercise raises both body temperature and heart rate, which are not conditions conducive to great sleep. This means that afternoon or early evening may be the very best time for fibromyalgia patients who have difficulty sleeping to exercise.

Watch What You Have for Dinner

Research has found that certain foods tend to prevent truly restful sleep when they are consumed too close to bedtime. This means you should plan to eat dinner 5-6 hours before bed whenever possible, and limit the following foods if you must eat any later than that

Foods that are high in fat and protein, like red meat or fried anything. These are harder for your body to digest and throw of the Circadian rhythm that is largely responsible for helping your body understand it’s time to sleep.

Chocolate is another no-no. Not only does it contain caffeine but also other stimulants, including tyrosine and theobromine, amino acids that cause heart rate increases that are not conducive to sleep.

Spices are also best avoided too close to bedtime as their tendency to cause at least minor digestive issues may very well make getting to sleep even harder and staying that way even more so.

A Good Bedtime Routine

how long should i sleep
Photo by Malvestida Magazine on Unsplash

Sleep can often be improved by making sure you stick to a bedtime routine as far as possible, very similar to the one you may have had as a child in fact. What should this routine consist of?

Here are some basic pointers:

  • Do not eat anything heavy three hours before bed
  • Don’t exercise for at least three hours before bed
  • Try doing something relaxing right before bed, a warm bath or shower perhaps
  • Indulge in a warm drink, but nothing caffeinated. Good old warm milk is still a great option, even as an adult.
  • Invest in an old-fashioned alarm clock and leave your smartphone somewhere you can’t touch it. Electronics – that includes TVs and computers – of any kind should not be used at bedtime. In addition to overstimulating your mind some believe that the blue light they emit can cause headaches and eye strain!

Also Read: How Much Sleep Do We Need?


While some fibromyalgia patients find that traditional pain medications help them others do not, or they do not want to become dependent on potentially very addictive opioid pain medications that come along with their own set of complications and risks. Those people often prefer to investigate natural remedies.

One of the most promising, many feel now is CBD. CBD is a form of cannabis, but it does not contain THC, the compound that causes the euphoric effect in its primarily illegal -and at the very least extremely restricted – marijuana.

Research into the effects of CBD for fibromyalgia patients is ongoing, as the substance has only recently been made available legally and relatively easily. CBD is thought to especially effective for fibromyalgia as it is believed that it activates serotonin receptors which affect pain perception and tissue inflammation, both of which are usually major issues fibromyalgia patients deal with daily.

Much of the evidence, at this time, of CBD being helpful for those with fibromyalgia is anecdotal, from patients themselves, but a small batch of studies has found promise, especially in terms of decreased pain. However, the Food and Drug Administration (FDA) hasn’t approved CBD as a treatment option for fibromyalgia or most other conditions.

CBD is currently widely available to those over 18 in the US and is offered as liquid drops, ‘vape liquid’ or as edibles like gummies or cookies. As there are no side effects frequently reported many fibromyalgia patients are giving the supplement a try.

Disclaimer: Nothing on this website is intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The contents of this website are for informational purposes only.