How to manage poor sleep in fibromyalgia

Fibromyalgia is a lifelong condition that may cause physical symptoms such as persistent pain and fatigue.

Mood changes and memory problems are also common effects of fibromyalgia. Chronic pain, increased stress, and anxiety may lead to sleeping disturbances like insomnia. Not having enough rest can also intensify fibromyalgia symptoms.

What is the link between fibromyalgia and sleep disturbances?

People with fibromyalgia often experience sleep disturbances, including nightmares and insomnia. This is because chronic and intense pain may interfere with your ability to rest and relax.

Poor sleep quality may also lower your body’s opportunity to relax stiff muscles and increase your chances of depression and anxiety. In general, sleep deprivation tends to worsen fibromyalgia symptoms and may increase pain levels and depression symptoms in people who don’t have the condition.

How to sleep better with fibromyalgia

If you live with fibromyalgia, you may benefit from optimal sleep hygiene, even if you don’t experience sleep disturbances.

These strategies may help you sleep better if you have fibromyalgia:

Exercise and physical activity

Physical activity guidelines for adults in the United States advise at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous aerobic activity every week. At least two strength training sessions may also increase overall health benefits.

Although possibly challenging, physical activity may improve fibromyalgia symptoms.

Being physically active for 30 minutes daily, 5 days a week, may also impact your sleep quality and decrease depression symptoms.

Physical activity does not necessarily mean a structured workout. Just moving more, in general, may help. For example, indoor walking, swimming, dancing, doing chores, and playing with pets and kids.

You may initially experience post-activity pain, especially if you’re not used to being active. It may be a good idea to avoid strenuous exercise, particularly when you experience fibromyalgia flare-ups.

Routine

Your habits may impact the quality of your sleep, and your sleep quality may affect your pain levels.

Creating a structured sleeping routine may help improve fibromyalgia symptoms, including sleep disturbances. Strategies may include:

• getting up at the same time every day, including weekends
• following the same steps every day before bedtime
• adding a relaxing component to your bedtime routine, like taking a warm bath or meditating
• avoiding heavy meals before going to bed
• setting the room at a temperature that feels comfortable to you
• choosing bed fabrics that are soft and cool
• getting rid of bedroom distractions, like lights or noises
• avoiding napping during the day, even if you feel tired

Relaxation techniques

Fibromyalgia flare-ups are often associated with stressful events, including lack of sleep.

Improving your stress levels may help you cope with chronic pain and sleep disturbances in fibromyalgia.

You may want to consider including these stress management techniques for fibromyalgia in your daily routine:

Limit caffeine

Although every body is different, you may notice some improvement if you limit alcohol and caffeine consumption. Avoiding caffeine for at least 6 hours before bedtime is highly advised.

Support therapies

Psychotherapy may also help you cope with the mental effects of fibromyalgia and poor sleep.

Acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) are often recommended if you live with chronic pain and insomnia.

Acupuncture may also help relieve fibromyalgia localized pain. However, more research is needed to confirm its long-term benefits in treating chronic pain.

How is fibromyalgia treated?

Besides psychotherapy, sleep hygiene, and lifestyle measures, your healthcare professional may recommend some medications to manage fibromyalgia symptoms.

The type of medication they prescribe may depend on your symptoms and their severity.

Over-the-counter pain relievers may help with mild to moderate pain. Severe pain, sleep disturbances, fatigue, and depression or anxiety may require prescription medications, including:

• serotonin and norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) 
• tricyclic antidepressants like amitriptyline (Elavil)
• nonbenzodiazepines like zolpidem (Ambien)
• anti-seizure drugs like pregabalin (Lyrica) and gabapentin (Neurontin)
• pain relievers like acetaminophen or tramadol (Ultram)
• muscle relaxants like cyclobenzaprine (Amrix)

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Summary

Fibromyalgia may lead you to experience sleeping disturbances like nightmares and insomnia. Poor sleep quality may, in turn, increase fibromyalgia symptoms like pain and fatigue.

Building a bedtime routine, avoiding heavy meals and caffeine before sleep time, using psychotherapy, and getting physical activity may help you cope with fibromyalgia-related sleep deprivation.

It’s also possible that your healthcare professional recommends medications to manage fibromyalgia and sleep disturbance symptoms.

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