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Growing evidence implicates oxidative stress and mitochondrial dysfunction in fibromyalgia (FM), prompting interest in redox-modulating therapies ( High-dose thiamine (600–1,800 mg/day) has shown promise in improving fatigue and pain in FM, likely by enhancing mitochondrial function and reducing oxidative stress ( NRF2-activating agents may improve both pain and sleep in FM by enhancing antioxidant defenses, mitochondrial function, and reducing neuroinflammation ( Melatonin supplementation (3 mg/day) has been shown to improve objective and subjective sleep quality, increase 6-sulfatoxymelatonin levels, and enhance total antioxidant capacity in FM patients, suggesting dual chronobiotic and antioxidant benefits ( Mitochondrial-targeted therapies such as CoQ10, alpha-lipoic acid (ALA), and carnitine have been investigated for their role in improving ATP production, reducing oxidative stress, and enhancing cellular metabolism