13 Tips for Getting a Better Night’s Sleep with Fibromyalgia

13 Tips for Getting a Better Night’s Sleep with Fibromyalgia

By Donna Gregory Burch

How did you sleep last night? If you have fibromyalgia, your answer is probably not very well. I know the feeling! I’ve struggled to get a good night’s rest for years.

Donna Gregory Burch

Unrefreshing sleep is one of the primary symptoms of fibromyalgia. No matter how much we sleep, we still wake up exhausted. Multiple research studies have confirmed our disordered sleep. We don’t spend enough time in the deeper, more restorative stages of sleep, and some studies have also shown that we have what are called alpha wave intrusions, which are associated with wakefulness, during the deeper stages of sleep.

“At this point, there are a lot of mysteries about why fibromyalgia patients don’t sleep well, why they’re fatigued and what causes this, but unfortunately the findings we do have don’t tell us very much about what to do about getting deeper sleep,” said Dr. Karl Doghramji, director of the Jefferson Health Sleep Disorders Center in Philadelphia.

Until researchers figure it out, there are a few steps we can take to try to improve our sleep quality. I reached out to three different sleep experts around the country and asked them to share their best advice for getting better sleep with fibromyalgia. Below are their most useful tips.

  • Getting a good night’s sleep actually starts in the morning. “It is essential to either be exposed to natural sunlight or a light box, such as [the] goLite, for the first hour of waking up to be able to maintain a good circadian rhythm,” said Catherine Chua, behavorial sleep medicine specialists at Mt. Sinai Integrative Sleep Center in New York City. Going for a short walk or doing some light exercise in the morning can help stabilize the circadian rhythm, too. (Yes, I know it’s hard to exercise with fibro!)
  • Keep a consistent sleep schedule. “It’s critical for fibro patients to keep regular bedtime hours,” Doghramji said. “By regular, I’m emphasizing more the time they get up in the morning [and] not so much the time they go to bed at night. The time one gets up in the morning is a strong determiner of one’s next 24-hour circadian rhythm, including the time the person is likely to fall asleep the next night, so regularity is of critical importance. That applies to weekends and weekdays and vacations as well.”
  • Consider getting a sleep study. “If you have frequent interruptions in your sleep, daytime drowsiness, unusual movements during sleep, snoring or breathing pauses, and/or difficulty falling/staying asleep that you believe are not due solely to your fibromyalgia, you should discuss these symptoms with your primary-care physician or sleep specialist,” said Dr. Clete Kushida, medical director of the Stanford Sleep Medicine Center in Stanford, California. Sleep apnearestless legs syndrome and periodic limb movement disorder are all common comorbidities in fibromyalgia patients. The diagnosis and treatment of these disorders can improve sleep.
  • Take an afternoon siesta. For those who are able to nap, “I do recommend a brief nap in the afternoon around 1 p.m. or so, something along the lines of a 15-minute or half hour nap – no more than that,” Doghramji said. “If you nap more than that, it can actually disrupt your next night’s ability to sleep well.”
  • Wind down and relax for a couple of hours before going to bed. Read a non-stimulating book. Meditate. Listen to calming music. Take a warm shower or bath to relax your muscles.
  • Put down the mobile devices, turn off the TV and dim the lights. “Try to eliminate as much light as possible for a couple of hours before sleep,” Doghramji said. “Light has a way of disturbing circadian rhythms by diminishing melatonin levels, so making the environment as dim as possible for a couple of hours before bedtime may be helpful.”
  • Block the blue light. If you absolutely have to use your mobile devices or watch TV before bedtime, consider purchasing a pair of blue-light-blocking glasses. (You can buy inexpensive ones on Amazon.) For Android smartphone users, there are blue-light-blocking apps that you can download. Newer iPhones and iPads come with a built-in “night shift” option. If you have older devices, Amazon sells blue-light-blocking screen protectors. For laptops and desktops, you can download f.lux.
  • Avoid overeating or drinking excessive fluids. Eating too much close to bedtime can cause acid reflux and tummy troubles. Drinking too many fluids will have you visiting the bathroom all night long.
  • Avoid alcohol close to bedtime because it can disrupt sleep.
  • Invest in a quality bed. “Ensure that your bed surface/mattress is good and does not cause exacerbation of your fibromyalgia,” Kushida said.
  • Make sure your bedroom is as dark as possible. Cover or replace bright alarm clocks and other device lights. Install room-darkening shades.
  • Try progressive muscle relaxation. “From my clinical experience, patients with chronic pain find progressive muscle relaxation helpful as tensing and releasing different parts of the body helps individuals relax and improve pain and sleep issues,” Chua said.
  • Seek help. “Don’t suffer too long,” Doghramji advised. “Go see a doctor. If you don’t get the right answer from your family doctor, or they just jump right to a sleeping pill, go to a specialist. There are a lot of sleep specialists out there who can be helpful, and I think they’re underutilized by fibromyalgia patients.”

I also asked if there were any supplements or prescription sleep aids that might be helpful for improving deep sleep. Here are their responses:

  • Chua: “Gabapentin is found to be effective in increasing slow-wave sleep, which is often referred to as deep sleep. The physicians I work with often prescribe it at a low dose for patients who have sleep efficiency but complain about the quality of their sleep. Trazodone is another medication the sleep center uses to enhance sleep quality in patients.”
  • Doghramji: “In terms of supplements, the one that’s probably most researched is melatonin, but there’s no good evidence on what dose should be used. I typically recommend a low dose close to bedtime, something like 1 milligram or so, maybe a half hour before going to bed. Some people will take that, and nothing happens. For those, I recommend a gradual dose increase up to 3 milligrams. … There are three medications which are meant to not only help you fall asleep but stay asleep, and those are Ambien extended release or Ambien CR (generic name: zolpidem), Lunesta (generic name: eszopiclone) and Belsomra (generic name: suvorexant). They’ve been shown in patients who have difficulty with sleep initiation or maintenance to actually improve the quality of sleep. One of their major negatives as a collective group is that they can cause daytime sedation. Secondly, all three medications have a Drug Enforcement Administration scheduling. What that means is they may have a tendency for an increased likelihood for abuse and diversion. Thankfully, that tendency is not that high with these drugs. Long-term studies have shown that people tend not to escalate the use of these drugs in general.” These drugs are typically not recommended for people with a history of drug abuse.
  • Kushida: “There aren’t any medications that I would recommend unless first being evaluated by a sleep specialist. The best treatment for chronic insomnia would be cognitive behavorial treatment for insomnia.”

So, now it’s your turn … What are your best strategies for improving your sleep? Share in the comments below! 

Donna Gregory Burch was diagnosed with fibromyalgia in 2014 after several years of unexplained pain, fatigue and other symptoms. She was later diagnosed with chronic Lyme disease. Donna covers news, treatments, research and practical tips for living better with fibromyalgia and Lyme on her blog, FedUpwithFatigue.com. You can also find her on Facebook and Twitter. Donna is an award-winning journalist whose work has appeared online and in newspapers and magazines throughout Virginia, Delaware and Pennsylvania. She lives in Delaware with her husband and their many fur babies.

Subscribe to our blog via email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Authored by: Donna Gregory Burch

There are 5 comments for this article
  1. Greg D-R at 9:48 pm

    This is good advice for anyone. I have Complex Regional Pain Syndrome and we also have sleep issues. I understand part of our issue is our disease affects the Limbic system which is why a person who always got up at 6am continues to do so after they retire. I would say it’s the habit system. Also CRPS affects the autonomic nervous system (fight or flight) and that is said to affect sleep. I try to get up at the same time everyday as it helps.
    Thanks for the great tips & have a super day!

  2. Gary Bryer at 9:56 pm

    Hi. I’ve was diagnosed with fibromyalgia and chronic fatigue, after going through every test my doctor could think of to rule out any similar condition or disease. I’ve had sleep studies that revealed that I was getting between 4 minutes and 11 minutes of rem sleep a night. Plus, even though I was asleep, I was awake at the same time. Something to do with Delta was and Alpha was overlapping. Sleep studies were another way to confirm fibromyalgia (and narcolepsy). At any rate, I have never had restorative sleep, ever. I thought this was normal. Now I know better. I tried Ambien. I tried melatonin. I use Benedryl to help me get to sleep; and that provides some measure of help. I also like listening to old time radio shows. They seem to capture my attention, so I’m not aware of what’s going on around me. No stimuli. Problem is I only sleep a few hours at a time, I’m tired as heck, but I can’t fall back to sleep. I’ll keep trying, it helps if for no other reason than to rest my body. Another problem with sleep and fibromyalgia is when I sleep more than 3-4 hours, my body explodes with pain. All over. Which is a lousy way to start the day. After almost 20 years, it’s like the movie “Groundhog Day”. Every day starts the same, and ends the same way. There is something to be said for consistency.

  3. Abot Bensussen at 7:40 pm

    The only and best way I can get, deep and refreshing sleep, with my fibro and sleep apnea (both types) is with Xyrem, (sodium oxybate). I’ve been using it for over ten years, and it’s been a tremendous help. My neologist prescribes. It for me.

    Pilates is the only exercise I take. It’s kept my core strong and my balance. Improved. So sorry there is still no cure. No real treatment. I live on opiates and sleep with a mask and my C pap machine.

  4. Jean Price at 12:18 pm

    A well written, well researched, and informative article, Donna! Like all of yours are! Sleep is such an important part of health and overall wellness! Yet we often overlook this…or just don’t assign it a place high up on the list of what CAN affect us the MOST…WITH PAIN OR WITHOUT PAIN! Having a sleep study is a big step in finding out how sleep IS IMPACTING our pain and our general health, and its the ONLY WAY to know what’s best to treat any problems or disorders we may have! Especially true since you don’t have to snore or have episodes of noisy breathing to STILL have various forms of sleep apnea disorder…which WILL stop you from obtaining the important levels of restorative sleep we ALL need!

    Sleep apnea can be an obstructive type, yet can also be what’s known as “clear airway apnea” or central apnea…where your brain just “forgets” to breathe, to put it simply! If this is the case, a regular C-Pap machine won’t be helpful in stopping the periods of apnea, and a Bi-Pap machine or other type of device is needed. For some, added oxygen is also needed while sleeping, which can be given with the sleep device.

    Since having a sleep study with a good clinic is a way to know what our sleep issues may be…it’s well worth the time and energy…AND INCONVENIENCE to have one! For really anyone, since sleep—and lack of sleep can influence so much of our bodies’ normal functioning and lead to many diseases and difficulties! This includes strokes, accidents, high blood pressure, and even difficulties controlling blood sugar and impotency! Lack of good sleep and sleep deprivation also can both greatly reduce our coping abilities of living with pain AND increase the actual levels of pain we have from day to day! Although some sleep clinics do administer the sleep study test at home, I have both read and been told these aren’t as detailed and don’t closest as much data…therefore going to the facility may be the better plan. Facilities usually allow you to follow your bedtime rountine as much as possible, and have your own pillows…and they provide a comfortable bed, a soundproofed room and even ways to have “white” noise if you need this to get to sleep. (However, they do like you to sleep on your back, which can be difficult for some…and yet they will likely be flexible in this if you positively need to sleep in a different position!)

    Sleep studies look at several factors…like our average hourly apnea events or sleep disruptions, the number of respiration a minute, the rhythm of our breathing, our snoring, our oxygen saturation, our brain activity during sleep, body movement during sleep, and other factors which correlate to the various levels of sleep. The test comes up with a lot of data, including a number…the AHI…which is assigned to the average hourly interruptions of sleep you experience in a night.

    These times would be similar to having a person standing by your bed and saying your name, or calling out to you…while you slept! So it represents times of interruptions of sleep, with enough of a breakthrough to keep you from achieving the most important levels…where your body can replair and restore itself!! Too many incidents of this kind of sleep disruption can definitely affect your health…and your pain! And this is also an important measurement in “qualifying” for insurance coverage for the sleep apnea equipment needed. It also is a good indicator of how well the therapy is helping your sleep overall, once you start it.

    Most insurance plans will cover the machinery like a monthly rental, until the cost of the equipment has been met…then it’s yours to keep, with no futher costs except supplies. And most insurance will also cover the needed supplies of masks, tubing, and filters…during the course of treatment, which can be a life long issue, although weight loss and other factors CAN help decrease sleep apnea for some people. (We are all so different, so routines and treatments and even medications don’t affect us all in the same ways. Our care has to be individualized to work well and give us the best personal results.)

    Something I recently found out…many people use benadryl for a sleep aid, yet I was told by a sleep specialist this can actually interfere with sleep! So you may want to check this out, if you use it! Many factors affect our sleep, and this article addresses the most important ones, I think! There are both general and specific things WE can do to help ourselves have better sleep, whether we have an underlying sleep disorder or not, or whether we live with pain or not! Yet, like all health related “pointers”, these vary in how much any particular one will affect us, as individuals. This makes it important to keep them ALL in mind…especially since pain is such a drain on our bodies overall and we go through many changes over the year. Anything we CAN do will go a long way toward making life better and easier for us…since we are unfortunately at a time now where life with pain is so much harder than it needs to be! Making this type of information extremely important for us to know…and to follow through with as needed, to help ourselves!

Leave a Reply

Your email address will not be published. Required fields are marked *