Tired of being tired? For those living with fibromyalgia, restful sleep can feel out of reach. Chronic pain, fatigue, and cognitive disturbances disrupt the body’s natural sleep rhythms, leaving patients drained day after day. While medications and pain management are part of the solution, new research suggests that exercise may be the key to unlocking better sleep and better days for fibromyalgia patients.
At Arthritis, Rheumatic & Bone Disease Associates (ARBDA), we’ve seen firsthand how strategic lifestyle changes can dramatically improve our patient’s lives. Exercise can reduce pain, calm the nervous system, and make it easier to fall and stay asleep.
Understanding Fibromyalgia and Its Impact on Sleep
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness. The most common symptoms are deep exhaustion, “fibro fog” (cognitive dysfunction), and disturbed sleep.1 Studies estimate that more than 75% of fibromyalgia patients experience non-restorative sleep, where they wake feeling just as tired as before going to bed.2
Why is sleep so elusive for people with fibromyalgia? When the brain is constantly on high alert due to pain, it becomes difficult to cycle into the deeper stages of sleep, particularly slow-wave sleep, which is critical for healing and restoration.3 Poor sleep leads to more pain, and more pain disrupts sleep — an exhausting loop that’s tough to break without intervention.
The Connection Between Exercise and Sleep Quality in Fibromyalgia Patients
Though it may seem counterintuitive to exercise when in pain, research supports physical activity as one of the most effective non-pharmacological treatments for fibromyalgia.
A recent meta-analysis published in Arthritis Care & Research found that land-based aerobic exercise combined with flexibility training was the top non-drug therapy for improving sleep quality. Aquatic aerobic exercise also demonstrated notable sleep benefits, offering a gentler option for those with joint sensitivity or mobility challenges.4
Other studies have also shown that consistent exercise reduces pain sensitivity, decreases fatigue, and improves sleep quality.5,6 How? Because exercise promotes deeper sleep by reducing stress hormones like cortisol and increasing serotonin and endorphins, which are linked to better mood and relaxation.6,7
For fibromyalgia patients, this can translate into fewer nighttime awakenings, longer periods of uninterrupted sleep, and more restorative rest. In fact, multiple studies confirm that those who engage in aerobic exercise report improvements in both sleep duration and quality over time.4,8
Types of Exercises Beneficial for Fibromyalgia-Related Sleep Issues
When it comes to choosing the right kind of exercise, it’s essential to consider gentleness, consistency, and personal preference. The following types of movement have been shown to be particularly beneficial:
Aerobic Exercise
Low-impact aerobic activities like walking, swimming, or cycling can help increase heart rate without overexertion. A 30-60 minute session, three to five times per week, can help improve pain levels.9,10
Stretching and Flexibility Routines
Gentle stretching, yoga, and tai chi are ideal for improving flexibility, reducing muscle tension, and calming the nervous system before bedtime.10,11,12 These exercises support better range of motion and help prepare the body for sleep.
Strength Training
Light resistance training, such as using resistance bands, helps build muscle strength without taxing joints.10 Stronger muscles can better support the body, reducing the strain that contributes to fibromyalgia pain and sleep disturbances.
Aquatic Therapy
Water exercises performed in a warm pool reduce impact on joints while still offering cardiovascular and strength-building benefits.10,13 Many fibromyalgia patients find aquatic therapy especially soothing and sleep-promoting.
Additional Lifestyle Changes to Enhance Sleep Quality
While exercise plays a central role, it works best as part of a holistic sleep-support strategy. Several other lifestyle changes can further improve your sleep:
First, prioritize a consistent sleep schedule. Going to bed and waking up at the same time each day helps regulate your circadian rhythm, making it easier to fall and stay asleep. Creating a calming pre-bedtime routine, such as warm baths, gentle stretches, or listening to soft music, can also signal to the body that it’s time to wind down.
Second, pay attention to your sleep environment. A dark, cool, and quiet bedroom promotes deeper sleep. Minimize screen time at least one hour before bed, as blue light disrupts melatonin production. If needed, explore tools like blackout curtains, white noise machines, or supportive mattresses and pillows designed for people with chronic pain.
Tips for Staying Motivated and Consistent with Exercise
Starting an exercise routine is one thing — sticking with it is where most people run into trouble. For patients with fibromyalgia, motivation can be especially challenging when pain and fatigue are daily obstacles. But with the right mindset and a few strategic habits, long-term success is well within reach.
Set Realistic, Achievable Goals
Instead of aiming for dramatic changes overnight, focus on small, attainable goals. Start with just 10 minutes of movement a day and build from there. Celebrate each milestone, no matter how small, because it all adds up. Keeping an exercise journal or using a tracking app can help visualize progress and reinforce consistency.
Choose Enjoyable Activities
If you dread your workouts, chances are you won’t stick with them. Try a variety of activities and find what feels good. Enjoyment is key to making exercise a sustainable part of your routine, and it turns a chore into something you look forward to.
Find an Accountability Partner
Whether it’s a friend, family member, or support group, having someone to check in with can make a world of difference. Consider joining a fibromyalgia-friendly exercise class or an online community where you can share progress and encourage each other.
Adapt When Necessary
Some days will be harder than others, and that’s okay. If your body needs rest, listen to it. On flare-up days, swap your usual workout for light stretching or deep breathing exercises. Flexibility helps you stay consistent over time without risking burnout or injury.
Speak with New Jersey’s Trusted Fibromyalgia Specialists Today!
Exercise isn’t a cure-all, but when combined with medical guidance and lifestyle adjustments, it can improve sleep quality and quality of life for those living with fibromyalgia or autoimmune disease. If you’re struggling with fatigue and pain, the first step is having an open conversation with your primary care doctor. Together, you can determine whether an exercise-based approach may support your overall treatment plan.
At ARBDA, we offer comprehensive, personalized care from board-certified rheumatologists who understand the complexities of fibromyalgia. If your doctor agrees that a referral is the next right step, our team will work closely with you to create a plan tailored to your unique needs. From medication management to sleep support and lifestyle coaching, we’re here to help you thrive — not just survive. Get in touch with New Jersey’s top rheumatologists today.
1https://www.niams.nih.gov/health-topics/fibromyalgia
2https://pubmed.ncbi.nlm.nih.gov/22381437
5https://pmc.ncbi.nlm.nih.gov/articles/PMC5461882/
6https://pmc.ncbi.nlm.nih.gov/articles/PMC10503965/
7https://pubmed.ncbi.nlm.nih.gov/35777076/
8https://www.archives-pmr.org/article/S0003-9993%2820%2930434-2/fulltext
9https://www.cochrane.org/CD012700/MUSKEL_aerobic-exercise-adults-fibromyalgia
10https://pmc.ncbi.nlm.nih.gov/articles/PMC3165132/
11https://pmc.ncbi.nlm.nih.gov/articles/PMC7014847/
12https://pubmed.ncbi.nlm.nih.gov/29563100/
13https://pmc.ncbi.nlm.nih.gov/articles/PMC6613198/
