Treatments for Insomnia in Fibromyalgia

Insomnia—trouble falling asleep, staying asleep, or waking too early—is extremely common in fibromyalgia. It can make pain, fatigue, and brain fog worse, so treating it should be a priority, in my opinion. 

Personally I have had a long history of difficulty falling asleep, mainly due the inability to relax my muscles with Fibromyalgia. I also wake often, due to pain. I snore, which I think may be a contributing factor in waking often. I have vivd dreams that wake me. I also occassionally get night terrors which really are terrifying, especially the first time you get them and think there is someone else in the room. 

Considering all these symptoms I'm surprised that I have had Fibromyalgia for 30 years before anyone suggested a sleep study! I will be writing more about that soon. 

Here I have a summary of everything I have been told that helps insomnia. 

🌙 Treatments for Insomnia in Fibromyalgia

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🧠 1. Cognitive Behavioral Therapy for Insomnia (CBT-I)

Gold standard treatment—especially effective for chronic insomnia.

• Helps reframe negative thoughts about sleep

• Teaches relaxation and sleep restriction techniques

• Typically done with a therapist or through apps like Sleepio or CBT-i Coach

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💊 2. Medications (used carefully)

For short-term or severe cases, your doctor may suggest:

• Amitriptyline (low dose): Common in fibromyalgia for pain and sleep

• Trazodone: Often prescribed for sleep in chronic pain patients

• Cyclobenzaprine: Muscle relaxant that also promotes sleep

• Zolpidem (Ambien) or eszopiclone (Lunesta): Short-term use only

• Doxepin (Silenor): Low-dose for sleep maintenance

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🌿 3. Natural Supplements

Use with medical guidance:

• Melatonin: Regulates sleep-wake cycles (especially helpful for circadian rhythm issues)

• Magnesium: Can help muscles relax and support sleep

• Valerian root or chamomile: Herbal remedies for calming the nervous system

• CBD or CBN (cannabinoids): Some report sleep benefits, but evidence is still emerging

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🛏️ 4. Lifestyle & Sleep Hygiene

Everyday habits make a huge difference:

• Set a fixed sleep and wake time (even on weekends)

• Avoid naps longer than 30 mins

• Create a relaxing bedtime routine (no screens, warm bath, soft music)

• Keep the bedroom cool, dark, and quiet

• Limit caffeine and alcohol after noon

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💪 5. Gentle Exercise (Timing Matters!)

• Daytime movement improves nighttime sleep

• Avoid intense workouts close to bedtime

• Yoga, stretching, or tai chi can also calm the nervous system

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😌 6. Relaxation Techniques

Calm your mind before bed:

• Guided meditation or yoga nidra

• Breathing exercises (like 4-7-8 technique)

• Progressive muscle relaxation

• Journaling or gratitude lists to reduce nighttime rumination

Treatment options for many other sleep disorders common in Fibromyalgia can be found here.