Sleep and Chronic Pain

The Sleep-Pain Connection

Sleep and pain have a bidirectional relationship: pain disrupts sleep, and poor sleep increases pain sensitivity. Up to 88% of chronic pain patients report sleep problems, creating a cycle that can worsen both conditions.¹

How Pain Disrupts Sleep²

Difficulty falling asleep
Frequent night waking
Less time in deep sleep
Early morning awakening
Unrefreshing sleep

How Poor Sleep Worsens Pain

Increases pain sensitivity
Reduces pain inhibition
Increases inflammation
Worsens mood
Reduces coping ability

Sleep Improvement Strategies³

Sleep Hygiene

Consistent sleep/wake times
Cool, dark, quiet bedroom
Avoid screens before bed
Limit caffeine and alcohol
Regular exercise (not late evening)

Pain-Specific Strategies

Proper pillow and mattress
Supportive positioning
Pre-bed relaxation routine
Timing of pain medications
Address nighttime pain

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Most effective non-drug treatment
Works well for pain-related insomnia
Available in-person or online
Long-lasting benefits

When to Seek Help

Significant daytime impairment
Sleep problems lasting weeks
Snoring or breathing pauses
Restless legs

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? Sleep Med Rev. 2004;8(2):119-132.
Tang NK, Lereya ST, Boulton H, et al. Nonpharmacological treatments of insomnia for long-term painful conditions: a systematic review and meta-analysis of patient-reported outcomes. Sleep. 2015;38(11):1751-1764.