Sleeping With Fibromyalgia

Written by Natalie Grigson, Writer

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Learn more about the impact fibromyalgia can have on sleep.

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Fibromyalgia is a long-term disorder with symptoms^[1] such as chronic pain, muscle and joint stiffness, digestive issues, and more. The discomfort that comes with fibromyalgia can make it difficult to sleep well, with experts adding that trouble sleeping and fatigue are accompanying symptoms.

The good news, though, is that there are things you can do to help improve your fibromyalgia symptoms and sleep quality. Some of these are lifestyle changes, while others include help from healthcare professionals. In this article, we’ll explain more about how fibromyalgia can affect sleep, different sleep issues linked to fibromyalgia, and the specific steps you can take to help alleviate your symptoms.

How Does Fibromyalgia Affect Sleep?

Fibromyalgia symptoms can present differently for different people, but one common denominator seems to be pain. If you’ve ever tried to go to bed with an injury or chronic pain, you know firsthand that pain can negatively impact sleep quality^[2].

It’s also true, though, that poor sleep can make pain worse^[3]. When we don’t sleep well, the parts of the brain that perceive pain and lessen it^[4] are impacted, making us more sensitive to pain. This creates a cycle in which pain leads to a lack of sleep and in turn, leads to more pain.

Other common symptoms of fibromyalgia are anxiety and depression^[5]. When these mental health issues are present, sleep can be greatly impacted. Anxiety, for example, can leave us with racing thoughts or even a fear of not being able to fall asleep, which is known as sleep anxiety^[6]. Likewise, depression has been linked to sleep difficulties, in particular, shortening the amount of restorative, slow-wave sleep^[7] we get each night.

Unfortunately, this lack of restorative deep sleep is a major problem for those with fibromyalgia. This is when the body fully relaxes and allows muscles, tissues, and energy to be repaired and restored^[1] – something that could greatly benefit those living with this condition.

Learn More: The Relationship Between Sleep and Pain

Sleep Problems With Fibromyalgia

Insomnia

Insomnia is a sleep disorder in which a person has trouble falling or staying asleep. Typically with insomnia, the person is aware of the issue; for example, they’d be aware of lying in bed, not being able to sleep, waking up during the night, or waking up too early in the morning.

For More Information: Best Mattresses for Insomnia

Lack of Restorative Sleep

Getting a lack of restorative sleep may feel less obvious. This is because even though you may get enough hours of shuteye, the quality of sleep has actually been poor. In fibromyalgia patients^[8], this can be due to frequent nighttime arousals, extended light sleep, and little slow-wave (deep) sleep.

Sleep Apnea

Whether fibromyalgia causes sleep apnea or sleep apnea causes fibromyalgia is still relatively unknown, but research^[9] has shown a connection between the two.

Sleep apnea is when your breathing starts and stops throughout the night. This leads to a drop in oxygen levels, which causes you to wake up abruptly to open up your airways. Sometimes those with sleep apnea are aware of these consistent nighttime awakenings and sometimes they aren’t.

If it seems like you’re getting enough sleep but still feel exhausted and unrested the next day, it could mean that you’re dealing with sleep apnea.

Having trouble with sleep apnea? Check out our list of best mattresses for sleep apnea.

Restless Legs Syndrome

Restless legs syndrome (RLS) creates an uncontrollable urge to move your legs^[10] and usually gets worse at night. This condition is prevalent in those with fibromyalgia. Though the connection is still being researched, it may have to do with inflammation in the body, a common underlying factor^[11] in both fibromyalgia and RLS.

Helpful Finds: Best Mattresses for Fibromyalgia and Best Mattress for Restless Leg Syndrome

Tips for Improving Sleep with Fibromyalgia

• Set a sleep schedule – Go to bed and wake up at the same time each day, including weekends. This will help train your body to start feeling more sleepy at the appropriate bedtime and better ensure you set aside enough hours of sleep each night.
• Use your bedroom just for sleep and sex – Avoid using your bedroom for work as this could associate your bedroom with stressful thoughts. Instead, your bedroom should be a source of peace for you that’s just set aside for sleep and sex.
• Get up and do something – If you have trouble sleeping, don’t lie in bed stressing out about it. Instead, get up and go into another room to do something calming such as reading, meditating, or drinking a cup of herbal tea until you get sleepy again. Then return to your bed to go back to sleep.
• Avoid stimulating activities before bed – This might include intense movies or books, working, exercising at night, or anything else that creates stress or causes your heart rate to go up.
• Avoid alcohol and coffee before bed – You should avoid caffeine up to six hours before bedtime, as it can cause issues in going to sleep^[2]. Alcohol^[12] can be equally disruptive, negatively impacting REM sleep and causing frequent nighttime awakenings.
• Exercise regularly – Experts^[13] say exercise is one of the most helpful strategies for both managing fibromyalgia pain and improving sleep. However, you’ll want to be sure the exercises you’re doing are safe for fibromyalgia. Harvard Medical School recommends starting out slow and doing low-impact exercises like walking, swimming, cycling, or weight training^[13]. Be sure to talk to your doctor before introducing any new exercises.
• Improve your sleep environment – When you go to sleep, your bedroom should be like a cave: dark, cool, and quiet. Make sure you’re avoiding screen devices like computers and cell phones for at least 30 minutes to one hour before bedtime since they emit blue light^[14], which can delay sleep onset. If you live in a city, you might want to invest in some good blackout curtains and a white noise machine.
• Cognitive Behavioral Therapy – Cognitive Behavioral Therapy (CBT) has been shown to improve symptoms of fibromyalgia^[15] like pain and mental health issues, as well as improve insomnia^[15].
• Supplements – Before trying medication, you might want to try supplements or more natural methods of getting to sleep. Magnesium supplements can be an excellent option for those with fibromyalgia, as it is both a natural sleep aid and helps relax the muscles. You may also try supplementing with melatonin or drinking chamomile tea before bed.
• Medications – Certain medications can help you get to sleep and stay asleep longer. The issue, though, is that they won’t necessarily help you get more of the deep, restorative sleep that those with fibromyalgia need^[2]. This is something you should talk to your doctor about in more detail.
• Treat the underlying issues – As covered, fibromyalgia can go hand-in-hand with other conditions like sleep apnea, anxiety, and depression. In order to improve fibromyalgia long-term, it’s important to treat these underlying issues. Additionally, CBT and other modalities of therapy can help address the underlying mental health component. Speak to your doctor or therapist about coming up with a holistic health plan that can help with some of these underlying issues.

Final Word of Advice

Fibromyalgia is a disorder that is still being understood. As such, there is no “cure,” and experts are still working on creating treatments that work.

However, lifestyle changes like creating an optimal bedroom environment and consistent bedtime schedule can help with the sleep aspect of the disorder, and adding low-impact exercise and certain supplements or medications may help manage your other symptoms. Talking to your doctor and a therapist can help treat some of the underlying issues that often go with fibromyalgia.

Natalie Grigson

Writer

About Author

Natalie is a content writer for Sleep Advisor with a deep passion for all things health and a fascination with the mysterious activity that is sleep. Outside of writing about sleep, she is a bestselling author, improviser, and creative writing teacher based out of Austin.

Combination Sleeper

References

1. “Fibromyalgia”. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Last modified June 2021.
2. “Fibromyalgia and Sleep”. Arthritis Foundation. Webapge accessed June 21, 2024.
3. Haack, Monika., Simpson, Norah., et. al. “Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications”. National Library of Medicine. 2020.
4. “Poor sleep can change your reaction to pain”. Harvard Health Publishing. 2019.
5. Galvez-Sánchez, Carmen M., Duschek, Stefan., Reyes Del Paso, Gustavo A. “Psychological impact of fibromyalgia: current perspectives”. National Library of Medicine. 2019.
6. “Sleep Anxiety”. Cleveland Clinic. Last modified June 13, 2021.
7. “Depression and Sleep: Understanding the Connection”. Johns Hopkins Medicine. Webpage accessed June 21, 2024.
8. Lawson, Kim. “Sleep Dysfunction in Fibromyalgia and Therapeutic Approach Options”. OBM Neurobiology. 2020.
9. Meresh, Edwin S., Artin, Hewa., et. al. “Obstructive sleep apnea co-morbidity in patients with fibromyalgia: a single-center retrospective analysis and literature review”. National Library of Medicine. 2019.
10. “Restless legs syndrome”. Mayo Clinic. Last modified March 1, 2022.
11. Stehlik, Romana., Ulfberg, Jan. “(Neuro)Inflammatory Component May Be a Common Factor in Chronic Widespread Pain and Restless Legs Syndrome”. Springer Link. 2020.
12. “How does alcohol affect your sleep?”. Piedmont Healthcare. Webpage accessed June 21, 2024.
13. Bilodeau, Kelly. “Fibromyalgia: Exercise helps — here’s how to start”. Harvard Health Publishing. 2020.
14. “Blue light has a dark side”. Harvard Health. 2020.
15. Heller, Heloisa L., Borges, Aline R., et. al. “Role of Cognitive Behavioral Therapy in Fibromyalgia: A Systematic Review”. Scientific Research. 2021.
16. “Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills”. Mayo Clinic. Last modified April 5, 2024.