There's no single "best" sleep aid for fibromyalgia; it depends on the person, but effective options include prescription drugs (like SNRIs, gabapentin, low-dose tricyclics), supplements (melatonin, Vitamin D), and non-drug therapies (CBT-I, good sleep hygiene, warm baths). Prescription options like SNRIs (duloxetine, milnacipran) help with pain and mood, while gabapentin and low-dose amitriptyline can improve sleep quality and reduce pain, often used together. Natural options like melatonin are popular for regulating sleep cycles, and addressing vitamin D deficiency may also help.
In patients with fibromyalgia, zolpidem,6 but not zopiclone,7 improved some of the sleep measures, but neither drug improved pain. Triazolam improved sleep and pain in patients with rheumatoid arthritis,8 whereas zopiclone only improved pain.
Fibromyalgia Accentuates Pain
As a result, all forms of pain hurt more than they otherwise would and even a small bruise can be a source of real anguish. Likewise, any toothache or gum infection will be a far more intense and uncomfortable experience for someone suffering from fibromyalgia.
Doctors sometimes recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to ease deep muscle and joint pain caused by fibromyalgia. NSAIDs, such as ibuprofen and naproxen, are available without a prescription.
Lifestyle changes to help improve sleep quality with fibromyalgia
By the very nature of the disease, it can be hard to get comfortable at night, as you grapple with joints that begin to stiffen once you're lying in bed and not moving around. This is especially true if you've had an overly active day.
Cyclobenzaprine (Flexeril)
Before Tonmya, cyclobenzaprine was used off-label for the treatment of fibromyalgia as a muscle relaxant. It is still used in many cases to address muscle stiffness and spasms. Clinical studies have shown that cyclobenzaprine can help with fibromyalgia-related muscle pain and stiffness.
TNX-102 SL (Tonmya; Tonix Pharmaceuticals), cyclobenzaprine HCl sublingual tablets, has been approved by the FDA to treat fibromyalgia in adult patients, making it the first new treatment approved for the musculoskeletal and chronic pain disorder in over 15 years and the fourth treatment approved overall.
Additionally, vitamin D deficiency has been associated with fibromyalgia-like symptoms, such as chronic widespread pain and fatigue, although the link between the two remains controversial [9,17]. Interestingly, vitamin D levels have been reported to be generally lower in FMS patients than in healthy controls [18].
Amitriptyline has an average rating of 7.6 out of 10 from a total of 1823 ratings on Drugs.com. 68% of reviewers reported a positive effect, while 16% reported a negative effect. Naproxen has an average rating of 6.8 out of 10 from a total of 684 ratings on Drugs.com.
Fibromyalgia is linked to reduced salivary secretions leading to dry mouth2. There are some strategies to manage dry mouth symptoms. Hydration is key: Drinking plenty of water throughout the day is crucial for managing dry mouth.
6 ways to manage your fibromyalgia
Unusual Symptoms of Fibromyalgia:
Paresthesia – Tingling, numbness, or "pins and needles" sensations in hands and feet. Phantom itching or burning sensations – Feeling itchy or a burning sensation with no clear cause. Dizziness and balance issues – Some people experience vertigo-like symptoms.
Pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran HCl (Savella)are medications approved by the FDA for the treatment of fibromyalgia. Fibromyalgia is a chronic disorder characterized by widespread pain and tenderness, general fatigue, and non-restful sleep.
Co-dydramol and co-codamol — These aren't usually recommended for more than three days as they are addictive due to their opiod content. They also contain paracetamol. These drugs mask pain and do not resolve the problem causing fibromyalgia.
In fibromyalgia, autonomic dysfunction causes a decrease in blood pressure, but early pilot trials show that propranolol may help regulate this drop. Patients with fibromyalgia often experience sympathetic nervous system overactivity; this treatment may help alleviate this condition.
The pain most often affects the muscles and the points where muscles attach to bones. These are the ligaments and tendons. Pain may start in one part of your body, such as your neck and shoulders. But any part of the body may be affected.
Vitamin B12 deficiency can also cause symptoms that affect your brain and nervous system (neurological symptoms), including: numbness. muscle weakness. psychological problems, which can range from mild depression or anxiety, to confusion and dementia.
Several rheumatic diseases can mimic fibromyalgia. These include sero-negative rheumatoid arthritis, ankylosing spondylitis, Lyme disease, polymyalgia rheumatica and lupus. They have symptoms of widespread pain along with joint involvement.
Cyclobenzaprine and tizanidine are muscle relaxants that may be used to help manage symptoms of fibromyalgia. These medications can reduce muscle tension and improve sleep, addressing common challenges faced by those with the condition.
Treatment options have historically been limited, and many patients report inadequate relief. On August 15, 2025, the U.S. Food & Drug Administration (FDA) approved a new treatment: Tonmya (cyclobenzaprine HCl sublingual tablets), marking the first new FDA-approved drug for fibromyalgia in more than 15 years.
There are no gold-standard treatments for fibromyalgia. Treatment is focused on symptom management. A multidisciplinary approach and individualized treatment plan that incorporates a combination of interventions can help improve outcomes.
Currently, there are no specific laboratory or imaging tests for fibromyalgia. The main symptoms—pain and fatigue—are similar to many other conditions, so doctors typically try to rule out other causes for your symptoms.
Best muscle relaxant herbs to ease pain include chamomile, lavender, arnica, valerian root, and peppermint. Chamomile tea contains thirty-six flavonoids with anti-inflammatory properties that soothe contracted muscles. Lavender oil reduces pain and inflammation through direct application to affected areas.
Prednisone, an anti-inflammatory drug, is often prescribed by doctors to relieve symptoms of fibromyalgia. While it may help with inflammation and, therefore, help a person feel better, it is important to note that it comes with some very dangerous side effects.