Are extreme headaches at bedtime a sign of fibromyalgia?

Possibly: There are many causes of headaches, they should always be evaluated to get the correct diagnosis and treatment. That being said, many patient with fibromyalgia complain of headache.

Chronic headaches: Chronic headaches could be due to an underlying medical condition like fibromyalgia. Use of medications like Ibuprofen and triptans on a frequent basis can cause headaches. Family history of headaches also predisposes a person to headaches. Other factors involved in headaches include stress, physical trauma, sleep disorders, and frequent caffeine. Consult a pain physician.