This RCT enrolled 47 fibromyalgia (FM) patients with chronic insomnia complaints. The study compared cognitive behavioural therapy CBT, sleep hygiene (SH) instructions and usual FM care alone. Outcome measures were subjective (sleep logs) and objective (actigraphy) total sleep time, sleep efficiency, total wake time, sleep latency, wake time after sleep onset and questionnaire measures of global insomnia symptoms, pain, mood and quality of life. Forty-two patients completed baseline and continued into treatment. Sleep logs showed CBT-treated patients achieved nearly a 50% reduction in their nocturnal wake time by study completion, whereas SH therapy and usual care patients achieved only 20 and 3.5% reductions on this measure, respectively. In addition, eight (57%) of 14 CBT recipients met strict subjective sleep improvement criteria by the end of treatment compared with two (17%) of 12 SH therapy recipients and 0% of the usual care group. Comparable findings were noted for similar actigraphic improvement criteria. The SH therapy patients showed favourable outcomes on measures of pain and mental well-being. This finding was most notable in an SH therapy subgroup that self-elected to implement selected CBT strategies.