Sleeping with Fibromyalgia: Tips and Tricks to Improve Sleep and Lessen Pain

Medically Reviewed by Dr. Takeesha Roland-Jenkins, a psychologist with master’s degress in neurobiology and developmental psychology and a doctorate degree in general psychology from Grand Canyon University.

---

Most people with fibromyalgia struggle with sleep problems. They have difficulties falling asleep or staying asleep, and even when they get enough sleep, they can still wake up feeling fatigued. This chronic fatigue negatively impacts work, happiness, and overall quality of life.

Unfortunately, this sleep deprivation can also exacerbate the chronic pain experienced by those with fibromyalgia. This intensified pain can in turn make sleep more challenging. This leaves fibromyalgia patients stuck in a difficult loop where their pain and insomnia continue to feed off of one another.

While there is unfortunately no cure for fibromyalgia, there are strategies that can improve symptoms and overall quality of life. One of the most important things to tackle is insomnia. We will share with you some of the strategies that patients with fibromyalgia have successfully used to improve their relationship with sleep, and with it, lessen their daytime fatigue and pain.

What Is Fibromyalgia?

Fibromyalgia is a chronic pain condition that is more common in women than men. It can occur at any age and impacts around 2-6% of the world’s population. Pain waves come and go, with periods of intense pain typically lasting days to weeks at a time. Other symptoms that can accompany fibromyalgia syndrome include:

• Insomnia
• Anxiety
• Depression
• Chronic fatigue
• Trouble thinking
• Muscle and joint pain
• Mood swings

Fibromyalgia is a musculoskeletal syndrome that is categorized as a rheumatoid condition, although it’s not a form of rheumatoid arthritis. “It is not known what causes fibromyalgia,” adds Dr. Roland-Jenkins, “but common symptoms of the chronic pain condition include chronic fatigue and muscle and joint pain.”

How Are Sleep and Pain Connected with Fibromyalgia?

Researchers have found that the duration, efficiency, and disturbance of sleep may be involved in the severity of pain. Meaning, the more trouble with sleep, the more intense the pain is likely to be. Conversely, the severity of pain can hinder the quality and quantity of sleep.

“It is common for fibromyalgia patients to suffer from a sleep disorder due to the severity of pain caused by the disease,” says Dr. Roland-Jenkins. “It would be wise to participate in a sleep study to learn more about your sleep patterns so you can learn about any underlying conditions that are attributing to poor sleep.”

People with fibromyalgia often have another sleep disorder. For example, around 50% of people with fibromyalgia also suffer from restless legs syndrome (RLS). With RLS, people experience an urge to move their legs when they are at rest, which makes sleep extraordinarily difficult. 

It is possible that underlying sleep disorders may be involved in the pathogenesis of pain. One study found that 50% of fibromyalgia patients had obstructive sleep apnea; the link between pain and sleep is very strong.

Strategies to Improve Sleep in Fibromyalgia Patients

In order to improve symptoms, patients should concentrate on both pain reduction and sleep improvement. We will review some of the best ways that scientists have found thus far to help improve sleep in those with fibromyalgia.

Sleep Medication and Supplements

There are many medications that have been found to improve sleep in fibromyalgia sufferers. These include:

• Cymbalta (duloxetine)
• Xyrem (sodium oxybate)
• Cesamet (nabilone)
• Elavil (amitriptyline)
• Lyrica (pregabalin)
• Flexeril (cyclobenzaprine)

Additionally, some patients report improvements using melatonin, valerian, or vitamin D supplementation. However, long-term use of these supplements, particularly melatonin and valerian, may result in their becoming less effective.

Talk with your doctor to determine what medications or supplements may be best for you. It can take trial and error before you come up with a medication schedule that provides relief.

Upgrade Your Mattress

The bed you sleep on plays a large role in your comfort. It’s important that your mattress properly suits your particular needs. If you have fibromyalgia, you need a surface that’s contouring, supportive, and plush. The best mattresses for fibromyalgia are foam based, with either memory foam or latex materials with a support layer at the base. You also may need to adjust your pillows, particularly if you deal with neck or shoulder pain.

Adjust Your Sleeping Position

Your sleeping position may be contributing to your pain. Sleeping on your side is the most popular position, but it may not always be the most comfortable (especially if your sleep surface is lacking). Side sleeping can lead to a build up of pressure on your hips, shoulders, and knees.

If you’re struggling with these pains but don’t have the option to adjust your sleep surface to meet these needs, you can try shifting to sleeping on your back. Sleeping on your back is the best position for maintaining proper spinal alignment.

Sleeping on your stomach is the worst. This position puts a lot of pressure on your neck and lower back. Try shifting to your back or side, or use a low-profile pillow to improve your alignment.

Exercise

Exercise is central to fibromyalgia treatment. Exercise can improve deep sleep, reduce sleep disturbances, and help with pain. When you add in exercise:

1. Do not exercise shortly before bedtime: Exercising early in the day can help improve nighttime sleep, but avoid working out within three hours of your bedtime or your sleep may suffer.
2. Try low-impact exercises: Exercise itself can be painful or taxing, so it is be helpful to do exercises that are low impact. Water aerobics, swimming, tai chi, and yoga are some of the best options.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a form of psychotherapy with the goal of altering negative thought patterns and behaviors. The idea is that some people can improve their sleep, pain, and overall quality of life through this non-invasive form of psychotherapy.

In a 2014 study published in the Journal of Behavioral Medicine, researchers examined the efficacy of CBT compared to a sleep hygiene education program when it comes to improving sleep and other symptoms of fibromyalgia. 

64 women with insomnia and fibromyalgia were assigned to either the CBT or sleep hygiene group. After 30 treatments of CBT, patients reported improvements in multiple sleep variables, fatigue, pain catastrophizing, anxiety, depression, and daily functioning. In comparison, the sleep hygiene group only experienced improvements in subjective sleep quality.

Because CBT is safe and may help to improve sleep, pain, and quality of life, it might be worth a try if you are struggling to find relief.

Do a Sleep Study

Fibromyalgia patients may find out they have a concurrent sleep disorder. Because of this, it is wise to find out if you have one as well. 

If you have serious sleep problems, talk to your doctor about getting a sleep study. This can help to identify underlying conditions like sleep apnea or others that might be making it hard for you to sleep through the night. Once you’ve identified specific sleep conditions or issues, you can find treatments that target them.

Take a Nap, But Not a Long One

“Be careful not to take long naps during the day,” warns Dr. Roland-Jenkins. “These can actually hinder your sleep at night. Instead, focus on shorter power naps.”

If you’re feeling particularly drowsy during the day, a 15-30-minute power nap might be just what you need to recharge your batteries. It’s important, however, not to overdo it. If you take a longer nap, it can make sleeping at night harder.

Even though it can feel good in the moment, it’s usually more important to work on improving your nighttime sleep than to get a few extra Z’s in during the day.

---

Closing Thoughts

Targeting sleep troubles is one way that fibromyalgia patients may find relief for pain, daytime fatigue, and mood difficulties. Work with your doctor, sleep specialist, or holistic medicine practitioner to come up with a plan for you.

Organizations and Support Groups for Fibromyalgia 

National Fibromyalgia Association

National Fibromyalgia & Chronic Pain Association

International Support Fibromyalgia Network

American College of Rheumatology

American Chronic Pain Association

NFMCPA Online Fibromyalgia Support Community

Living With Fibro

Fibromyalgia On The Mighty