Fibromyalgia is commonly accompanied by persistent pain, fatigue, disrupted sleep, and psychological symptoms that can restrict daily functioning. This systematic review examined recent evidence on the sleep-related effects of physiotherapy and rehabilitation, together with research linking physical activity to sleep in people with fibromyalgia. PubMed, Web of Science, Scopus, Google Scholar, DergiPark, and the ULAKBİM TR Index were searched for English- or Turkish-language original studies published from March 2016 to March 2026. Eligible reports involved individuals diagnosed with fibromyalgia, addressed a rehabilitation intervention or physical-activity exposure, included a sleep outcome, and were available in full text. Two reviewers independently screened the records and resolved disagreements through consensus. Seven studies were included. They investigated land- and water-based exercise, strength training, transcutaneous electrical nerve stimulation, cognitive behavioural therapy, therapeutic neuroscience education, graded motor imagery, craniosacral therapy, multicomponent rehabilitation, and exercise volume. The Pittsburgh Sleep Quality Index was the most frequently used measure. Several exercise-based and multicomponent programmes were accompanied by favourable sleep-related changes, with some studies also reporting lower pain and better physical function. Interpretation was further constrained by small samples, uncontrolled designs, variation in interventions and outcomes, and limited follow-up. Sleep may therefore be assessed alongside pain, function, and psychological status in fibromyalgia rehabilitation, while treatment conclusions should remain cautious until larger controlled studies using standardised sleep measures and longer follow-up are available.