How can you have good sleep hygiene with fibromyalgia when your pain levels are always so high?

It's tough : I hear you. It's tough. Basically it involves no caffeine or alcohol, daily exercise, no naps, and meds. I prefer Gabapentin or Lyrica (pregabalin) for this aspect of fibro.

Treat the cause: It looks like you are on meds that may help symptoms but do nothing to address the cause of fibromyalgia. See http://www.Endfatigue.Com/ and dr. Teitelbaum's books. A supplement called fibronol is proven to significantly help sleep in patients with fibromyalgia. See http://www.Fibronol.Com/clinical_test.Html magnesium taurate or glycinate and glycine are among other supplements that help sleep.

Chalenging: There has been a very old argument as to whether the sleep disorder or the pain comes first! the sleep disorder that is one of the diagnostic criteria seems to involve an imbalance between rem (dream) sleep and the deepest stage of sleep (stage 4) excessive dreaming is common and the feeling of awakening feeling like you worked all night is common. Tricyclic antidepressants are a treatment.