Part A:   DayTime

Perhaps you toss and turn in bed every night; watching the minutes tick by on your bedside clock. Or maybe you sleep, but can't maintain the deep sleep needed for rejuvenation. Sleep problems are among the most common complaints associated with fibromyalgia, and their effect range from memory impairment to muscle pain.

Medical experts strongly encourage people with fibromyalgia to focus on lifestyle changes rather than drugs to sleep better. But what works? We've talked to the experts and called the best of their suggestions, including a look at the controversial supplement melatonin.

Throughout the Day

Reduce stress. Techniques abound - meditation, breathing exercise, listening to relation tapes. Some forms of exercise, such as tai chi and yoga, can also be excellent stress relievers. In some situations, a therapist or counselor may help.

Manage your time. Pay special attention to your body's natural rhythms. If you're at your best between 10.00 a.m. and 2.00 p.m. target that time for exercise and your most demanding intellectual tasks. When you feel your energy wane, take a break.

Exercise regularly. Gentle aerobic exercise helps reduce stress and promote sleep. Some experts recommend avoiding exercise any later than 4.00 p.m., because it can keep you awake later in the evening; others suggest stopping three to four hours before bedtime.

Check medications closely. Some, such as prednisone or even over-the-counter cold medications, may act as stimulants, and if taken at dinner or bedtime, may impair sleep. Discuss all drugs, both prescription and over-the-counter (including dietary supplements), with your doctor. Adjusting dosages or times may help prevent negative effects on sleep.

Eat properly and avoid problem foods. Say no to coffee, colas, chocolate, black teas and other caffeine-laden food and drinks. Steer clear of acidic or spicy foods that might cause stomach discomfort. Don't eat a heavy meal before bedtime, you should finish eating at least four hours before lights out.

Avoid smoking and alcohol. Nicotine is a stimulant. Alcohol may make you drowsy at first, but can impair restful sleep.

If necessary, try to lose weight. Very heavy people who shed pounds may alleviate other problems that can disrupt sleep, such as loud snoring and sleep apnea (brief, recurrent, intervals when a person stops breathing during sleep).

Don't rely on naps. It's best to improve nighttime sleep, rather than try to play cat-up by napping. However, you may still need to rest your by doing quiet activities periodically during the day.

Part B: Night time

Drink enough, but not too much. In the evening, drink enough water and other caffeine-free and sugar-free fluids to quench your thirst, but not so much that you'll be dragging yourself to the bathroom in the middle of the night.

Don't loll in bed. Your bed is for you and your partner, period, not TV trays and piles of Sunday newspapers. Think of your bed solely as a place for sleep and sex.

As Bedtime Approaches

Dubbed good "sleep hygiene," these rituals help you train your body to ease into restful sleep:

Set regular times to go to bed - and wake up. Most people need between seven and nine hours of sleep, though some may need as little as six or as much as 10. Work within this range to find your natural cycle, but avoid making quick changes that may be counter productive.

Go to bed in good spirits. Don't tackle tough subjects with your partner right before it's time to go to sleep.

Take a warm bath. This helps relax tight muscles and improve circulation. Studies also suggest that a warm soak approximately 90 minutes before bedtime helps stimulate sleep.

Have a cup of herbal tea or a warm glass of milk. Some people find a cup of tea brewed from valerian (a natural herb that's a mild sedative; check health food stores) can help you relax and get ready of sleep. A warm glass of milk, or even a few cubes of cheese or a cup of yogurt, at bedtime might help too, because milk products contain tryptophan, a natural amino acid t hat has been found to promote sleep.

Follow a familiar routine. At roughly the same time each night, brush your teeth, put on your pyjamas, read a few pages of a favorite poem - whatever suits your bedtime routine.

Create the right environment. Try to make your bedroom conducive to sleep. Choose a bed that is comfortable and supportive. (Some people with fibromyalgia prefer waterbeds; others use high-density foam mattresses that old to their bodies). You might consider using a cervical pillow, which supports the neck and reduces strain. Choose bedding to suit the season. Make sure the temperature and humidity are adjusted for sleep - a cool room is best. Install light-blocking curtains or blinds. Keep the room quiet. For those who can't drown out inevitable night noises, try earplugs or a white noise machine, or a tape player that emits restful sounds such as gentle waves.

Get a massage. You don't need a professional masseuse to benefit from a gentle rubdown. In fact, the soothing touch of a loved one can become an important part of a bedtime routine. And if restless legs wake you during the night, gently massaging your legs can help you fall back asleep.

Getting Back to Sleep

What if you've done all this, and still can't go to sleep? Or perhaps you have dozed off, only to jolt awake again hours before dawn? Experts say you should go back through your whole nighttime routine to help nudge your body back into sleep mode.

If following good sleep hygiene doesn't work, you may need to visit your doctor, who might arrange a visit to a sleep clinic where your problem can be diagnosed and treatment prescribed.