In this article evidence is discussed related to the reciprocal features of sleep and pain across three chronic multisymptom conditions, referred to as functional somatic syndromes, that are disproportionately found in women. Light and fragmented polysomnography sleep patterns, although often of lesser severity, match subjective reports of nonrestorative sleep quality and excess risk for sleep-related disorders. Health ecology factors (personal and environmental) contributing to women’s vulnerability to these stress-embedded conditions and potential mechanisms related to emotional arousal and inflammatory/immune activation are discussed as linked to pain processing and poor sleep.