Sleep and pain are closely related because pain can negatively affect how well you sleep. Pain is an uncomfortable feeling that can result from injury or health complications, and it’s usually described as throbbing, burning, stabbing, aching, or pinching. The severity of pain varies, with most people having to rate their pain according to a scale.
The way you sleep may cause pain as well. Lying in certain positions or having a bed that doesn’t provide adequate support could trigger achiness. Therefore, if your rest is impacted by pain or causing it, you’ll likely need a combination of treatment and good sleep habits.
Along with impacting your daily life, pain can have a negative effect on sleep quality. There are multiple ways that pain affects sleep, including more sleep interruptions, anxiety, and longer sleep latency.
A diminished quality of rest creates a problematic cycle because this leaves you feeling tired and frustrated the following day. As a result, it may be harder for you to focus on school or work, and if it’s a chronic issue, this could lead to long-term health complications.
While pain is distracting enough, sometimes the fear of pain or the worry that it will interrupt your sleep can interfere with your schedule or desire to wind down. In other cases, pain and anxiety naturally occur together, according to Harvard Medical School. This is especially common with nerve-related disorders such as fibromyalgia because of the biological similarities between brain function during anxiety and pain.
When anxiety becomes intense, it can interfere with rest by causing increased muscle tension, aches, racing thoughts, and an elevated heartbeat.
Pain can increase the time it takes for you to fall asleep at night. If you have insomnia, you’re probably familiar with the long nights of staring at the ceiling, your phone screen, or the wall for hours before you fall asleep. No matter what you do, you just don’t feel tired. This is because sleep latency, or the time it takes to fall asleep, is longer in those with insomnia.
According to a 2000 study, this is probably due to a state of hyperarousal before bedtime. Think about it: discomfort creates arousal, and generally not the good kind. Have you ever been lost in your thoughts when you stubbed your toe, caught your hair in a car window, or banged your head? When we feel unpleasant, we’re instantly alert. Maybe that’s why pinching yourself helps to keep you awake.
However, when this discomfort is constant, it can get in the way of sleepy hormones by placing you in a semi-permanent state of arousal, inducing insomnia.
Yes, pain can affect your sleep positions. Experiencing pain can alter how you sleep because the discomfort will likely force you to adjust positions to feel more comfortable.
Lying on your back or your side is considered the best position for sleeping. Back pain could make it uncomfortable to rest in the supine position, though, and pain in the shoulder or hip could cause discomfort for side sleepers. Stomach sleepers with neck pain may need to move to the back or side sleeping for a more comfortable night’s rest.
Learn More: Best Mattress for Back Pain
Yes, sleeping in the wrong position can cause pain because it can lead to pressure build-up or poor spine alignment. The three sleep positions are the side, back, and stomach. The least recommended sleep position by experts is on the stomach because it puts pressure on the spine and forces you to turn your head to the side, which could lead to back and neck pain.
Sleeping on your back or side could cause pain, too, particularly if your mattress does not provide sufficient pressure relief or support for your body frame. For example, heavier back sleepers could develop back pain if their mattress doesn’t prevent their heavier areas from dipping. When these areas sink too much, it throws off spine alignment, which could result in back pain.
The main sleep disorder caused by pain is insomnia. Insomnia is when a person has trouble falling or staying asleep. Pain can lead to insomnia by creating discomfort that delays sleep onset or prompts the individual to wake up throughout the night.
Yes, chronic pain can affect sleep. These effects include poor sleep quality and reduced sleep duration. Chronic pain is characterized by ongoing issues that last for weeks, months, or even years according to the National Institute of Health. People may experience chronic pain from an injury or health conditions such as cancer, fibromyalgia, or arthritis. Sometimes these conditions cause pain to flare up at night, resulting in sleep discomfort.
Chronic pain could lead to long-term sleep problems that exacerbate pain symptoms and worsen your mental and physical health. Good sleep is imperative for optimal health. When you don’t get enough quality rest, you can experience symptoms such as irritability, daytime drowsiness, trouble focusing, and less physical energy. Chronic sleep issues are also associated with long-term complications such as hypertension, heart attack, stroke, diabetes, obesity, and memory loss.
If you’re dealing with achiness that’s hindering your rest, consider trying out one or several of the following tips to help you sleep better with pain.
1. Relaxation techniques
2. Pain medications
3. Practicing good sleep hygiene
4. Adjusting your position
The drugs that can relieve pain and induce sleep include over-the-counter and prescription medications. Opioids are prescription medications for severe pain that can also cause sleepiness. Over-the-counter medications can also help mitigate pain for better sleep. You can purchase these medications at your local pharmacy without a doctor’s prescription. Certain sleeping medications specifically target nighttime pain and promote sleepiness, such as AdvilPM.
Some over-the-counter medications like ibuprofen and acetaminophen can alleviate temporary pain, but you should consult your doctor to establish a healthy treatment plan for chronic pain.
This is a great question to bring to your doctor because there is such a great variety of pain meds. However, when it comes to opioids, it’s probably best to not get in the habit of taking them for sleep. Chronic conditions and opioids have a complicated relationship of their own, but when it comes to rest, it’s pretty clear that opioids aren’t the best option.
Research has found that the use of opioids can reduce the amount of time you spend in slow-wave (deep) sleep. depriving your body of restorative rest that could help heal the body and reduce discomfort in some cases.
If you’re fighting intense postoperative discomfort, they could be a short-term option. However, when you’re dealing with chronic pain, you may get to sleep, but it could mean that your problems may become worse after a long night of rest, and the effect could compound. In any case, talk to your doctor about the side effects of your medication and the risk associated with using them for sleep.
CBD works by helping the body raise levels of anandamides and reducing swelling in the brain. These two functions could help reduce insomnia and pain. Unlike other strands of the Cannabis plant, CBD shouldn’t produce a “high” or alter your state of mind, in fact, some children with epilepsy even use it to help control their seizures. Keeping in mind that this drug is not regulated or legal in every country or state, various studies can vouch for its pain-relieving and sleep-inducing powers.
If you’re in an area where CBD is legal, your doctor should know what your options are for the management of your condition through CBD. They can discuss potential risk factors and the possibility of it interfering with the medication you are already taking.
Sleep hygiene refers to good habits designed to optimize your rest. Practicing positive nighttime habits is helpful because they increase the likelihood of getting quality rest. In an article from Harvard Medical School, Dr. Padma Gulur, a specialist at Massachusetts General Hospital says, “For chronic pain conditions, what you need is good sleeping habits from the beginning — things that will last.”
Some sleep hygiene best practices include a consistent sleep schedule, having a cool, dark, and quiet bedroom, keeping electronics out of your bedroom, avoiding large meals, caffeine, and alcohol before bed, and regular exercise.
Lastly, adjusting your sleep position may be necessary to get some sleep while in pain. For example, if you usually sleep on your back but your pain is worse in this position, try sleeping on your side or utilizing pillows to feel more comfortable. Finding a position that feels good will give you the best chance at quality sleep.
Sleep can affect pain in two ways. The first is that the way you sleep could exacerbate pain. For example, lying on your stomach could cause neck pain because your head is forced to turn to the side. A second example is that sleeping on your back without a well-supportive mattress could throw your spine out of alignment, triggering back pain.
The second way sleep affects pain is that worse sleep quality and sleep loss have been found to heighten pain symptoms. A 2018 study found that pain symptoms in participants worsened after a night of poor rest.
Yes, you can feel pain while sleeping, but it depends on the sleep stage you enter. There are four stages in a sleep cycle, and humans move through multiple cycles overnight. The first two stages are a lighter sleep, and therefore, you are more likely to be awakened by pain. The third stage is deep sleep, and the fourth stage is REM sleep. You are less likely to feel pain during these last two stages because your brain waves are at their slowest in a deep sleep, and the body is in a state of paralysis during REM sleep.
No, people don’t sleep more when they are in pain because the discomfort can make it harder to fall or stay asleep, resulting in shorter sleep times. First, pain can delay sleep onset because it is distracting and can cause anxiety around sleep, making it more difficult to relax. A relaxed mind is necessary to fall asleep. Secondly, pain symptoms can cause someone to wake up more frequently during sleep, particularly in the lighter sleep stages.
According to research from a study in Norway, better sleep could be the missing piece in rehabilitation for lower back pain. The study showed that the likelihood of recovery from lower back pain was directly associated with how well the patients slept. So reducing sleep problems could be key to improving pain.
According to the Cleveland Clinic, in some cases, patients who experience chronic pain are diagnosed with sleep disorders such as sleep apnea, and when the sleep problems are addressed, the pain goes away as well. We aren’t saying that this is the only solution for every type of pain, but there is certainly a relationship between the two.
Depending on why you experience pain, there may be other important factors to consider, but sleep is probably part of the answer.
Sleeping with chronic pain may seem like an uphill battle, but with a few adjustments, it could become much more manageable. Whatever the cause, the important thing is to keep trying to find what works for you and do your best to avoid habits that self-sabotage both your health and your rest. If there’s one thing we’ve learned from the research, it’s that better sleep means better management of your condition, and less discomfort means better sleep.
To get started on this upward cycle, we recommend talking to your doctor about the research to learn what’s best for your case.
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 “Chronic Pain”. National Institute of Neurological Disorders and Stroke. Last modified July 25, 2023.
 Hilton, Lara., Hempel, Susanne, et. al. “Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis”. Annals of Behavioral Medicine. 2017.
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