Sleep and Chronic Pain

The Pain-Sleep Connection

Sleep problems and chronic pain have a bidirectional relationship—pain disrupts sleep, and poor sleep makes pain worse. Up to 88% of people with chronic pain report sleep difficulties. Addressing sleep can be one of the most impactful interventions for pain management.¹

How Pain Affects Sleep²

Difficulty falling asleep
Frequent awakening
Difficulty finding comfortable position
Non-restorative sleep
Reduced deep sleep stages
Early morning awakening

How Poor Sleep Affects Pain

Increases pain sensitivity
Reduces pain threshold
Impairs pain inhibition
Increases inflammation
Reduces coping ability
Worsens mood (which affects pain)

Sleep Hygiene Basics³

Schedule

Consistent bed and wake times
Even on weekends
Avoid long daytime naps

Environment

Dark, quiet, cool room
Comfortable mattress and pillows
Remove electronics from bedroom

Pre-Sleep Routine

Wind down 30-60 minutes before bed
Avoid screens (blue light)
Relaxation techniques
Avoid caffeine after noon
Limit alcohol (disrupts sleep quality)

Pain-Specific Sleep Tips

Supportive pillows for positioning
Body pillow between knees (side sleepers)
Pillow under knees (back sleepers)
Gentle stretching before bed
Warm bath for muscle relaxation
Time medications for night coverage

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Most effective treatment for chronic insomnia
Works well even with chronic pain
Changes thoughts and behaviors around sleep
Available in person, online, or via apps
Effects are long-lasting

When to Seek Help

Sleep problems persist despite good habits
Snoring or gasping at night (sleep apnea)
Excessive daytime sleepiness
Restless legs at night
Need sleep medications frequently

Sleep Medications

Should be short-term when possible
Discuss with doctor
Some pain medications cause drowsiness
Be aware of interactions

References

Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552.
Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004;8(2):119-132.
Irish LA, Kline CE, Gunn HE, et al. The role of sleep hygiene in promoting public health: a review of empirical evidence. Sleep Med Rev. 2015;22:23-36.