Morning Symptoms of Fibromyalgia

Do your fibromyalgia morning symptoms include exhaustion, stiffness, aches, and maybe puffiness in your hands and feet or around your eyes? You're not alone. These are all part of the morning symptoms experienced by many people with fibromyalgia.

Not everyone with fibromyalgia has these morning symptoms, but they're quite common. This is one of those areas medical research hasn't yet explained. They also don't know a lot about alleviating them, other than what can be learned through trial and error.

A woman in bed awake
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Morning Exhaustion

It's pretty simple to sum up why people with fibromyalgia are exhausted first thing in the morning when healthy people feel refreshed and energized—they don't sleep well.

Fibromyalgia is linked to multiple sleep disorders, including:

  • Insomnia
  • Obstructive sleep apnea
  • Restless legs syndrome
  • Bruxism (teeth grinding)

Research also shows that some people with fibromyalgia have abnormal sleep patterns that interrupt our deep sleep as well as sleep that is generally unrefreshing.

Any one of these problems can leave you tired the next day. If you have several of them in combination, it's even harder to get good-quality sleep.

Then you add other fibromyalgia symptoms to the equation. Pain can certainly keep you awake or wake you up periodically. Anxiety makes it difficult to relax. Sensitivity to noise and light can make seemingly minor things jar you awake, possibly with a big shot of adrenaline.

For those people with a pain type called allodynia, even the brush of a sheet against your skin or a wrinkle in their pajamas can cause searing pain. Some people refer to fibromyalgia as the "princess and the pea" syndrome because, yes, people with the condition feel the tiniest things.

A lot of people with this condition complain of getting too hot and/or sweaty to sleep well. Temperature sensitivity is common in this disorder, and not just sensitivity to heat. A hand sticking out of the covers may get chilled to the point of discomfort or even severe pain, and can it take a long time to warm up. They are also prone to excessive sweating.

Depending on your symptoms, your healthcare provider may recommend a sleep study to diagnose sleep disorders. The findings could lead to treatments such as medications or a CPAP machine for sleep apnea, or to suggested lifestyle changes for improving sleep. Pain management and anxiety treatment can be an important part of helping you sleep better as well.

Morning Stiffness

It's fairly normal for people with fibromyalgia to wake up feeling stiff and achy all over or to have a hard time standing up straight for a while.

For many, the achiness tends to be different from other fibromyalgia pain. It's often more like the muscle pain a healthy person would feel the day after really strenuous activity or possibly a minor car accident.

It's not clear why their bodies are like this in the mornings. While they may feel pretty sedentary most of the time, people watching them often say that they are fidgety.

What happens is that a position makes something start to hurt, so they'll shift a little. Then something else starts hurting, so they shift again. It's possible that they're stiff in the morning because they haven't shifted around enough all night.

Some people find relief from morning soreness with a hot bath, possibly with Epsom salt, before bed. Others try simple yoga or other stretches before sleep or before getting out of bed. Medication, either for pain or sleep, may also help. Ask your healthcare provider for ideas and talk about things you'd like to try to make sure they're safe.

Morning Puffiness

Some people with fibromyalgia wake up with puffiness in their hands and feet or around their eyes. Again, science can't say for sure why.

The puffiness is generally believed to be the result of excess fluid, not inflammation. (Some cases of fibromyalgia may involve inflammation, though.)

Sometimes the puffiness doesn't cause problems, but it may be uncomfortable or painful. Common problems include pain putting weight on a puffy foot first thing in the morning, or clumsiness due to temporary loss of dexterity in the fingers. Using puffy hands to put makeup on puffy eyes can definitely be a challenge, too.

Sometimes, people say it helps to eat such foods as cucumbers that help relieve fluid retention. Others say they're helped by massage therapy, especially a specific type of massage called manual lymph drainage. Again, each person has to figure out what works best for them.​​

Some medications cause puffiness as well, so be aware of possible side effects and discuss them with your healthcare provider.

Fibromyalgia Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

A Word From Verywell

While these symptoms may cause problems waking up in the morning, they're not usually among the worst symptoms of fibromyalgia. Also, they're called morning symptoms for a reason—they generally clear up as the day goes along.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Roizenblatt S, Neto NS, Tufik S. Sleep disorders and fibromyalgia. Curr Pain Headache Rep. 2011;15(5):347-57. doi:10.1007/s11916-011-0213-3.

  2. Poluha RL, Grossmann E. Does pregabalin improve sleep disorders in fibromyalgiaBr J Pain. 2018;1(2). doi:10.5935/2595-0118.20180031

  3. Cassisi G, Sarzi-puttini P, Casale R, et al. Pain in fibromyalgia and related conditions. Reumatismo. 2014;66(1):72-86. doi:10.4081/reumatismo.2014.767

  4. Larson AA, Pardo JV, Pasley JD. Review of overlap between thermoregulation and pain modulation in fibromyalgia. Clin J Pain. 2014;30(6):544-55. doi:10.1097/AJP.0b013e3182a0e383

Additional Reading

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.