Is pain keeping you awake at night? There’s nothing worse than aches and pains preventing you from drifting off or waking you up after you doze off. Whether it’s your neck, back, joints, or nerves that are acting up at bedtime, trying to get comfortable enough to sleep is impossible. When you don’t sleep well, it not only makes your pain feel worse the next day, it also impacts your mood, focus, reaction times, and stress levels.[1]
If this sounds familiar, you are not alone. 65% to 95% of people with chronic pain conditions like arthritis and fibromyalgia experience sleep disturbances.[2] There is an indisputable connection between pain and poor sleep, and in recent years, it has often been the subject of medical studies.[2] A new term has even been coined to describe the sleep-pain link called “painsomnia”.[3] While it’s not a medical term, it does help describe insomnia due to chronic pain conditions.
You can break the cycle of pain and sleep deprivation. Let’s discuss why pain makes it so hard to sleep and what you can do to ensure you get the rest your body and mind need.
Why Pain Makes it Difficult to Sleep
Pain can rob you of a good night’s sleep, but why? Pain puts your body in a state of stress. Muscles may be tense, nerves are firing, and pain signals have your brain awake and on high alert. [https://www.webmd.com/sleep-disorders/features/pain-and-sleep] All of this makes it really tough to relax enough to fall or stay asleep.
Some pain medications that you take to control your pain can actually disrupt your sleep. A Japanese study has also found that pain can interfere with your circadian rhythm, your body’s internal time clock, and scramble up your sleep-wake cycle. The repeated sleepless nights can make you more sensitive to pain and exaggerate the pain you already experience.
Certain types of pain, like nerve pain, arthritis, or fibromyalgia, can flare up at night when you’re trying to rest. You may find yourself waking up multiple times or struggling to get into a comfortable position that doesn’t make the pain worse. Plus, the anxiety and stress about not sleeping can make it even harder to fall back asleep. It’s an endless cycle that can affect your physical and mental well-being.
Pain Conditions That Disrupt Your Sleep
Knowing what’s causing your pain is a great place to start. Understanding the root of your discomfort helps guide treatment and gives you clear steps to start feeling—and sleeping—better.
Here are some common culprits that cause sleep difficulty:
- Osteoarthritis
- Rheumatoid arthritis
- Lower back pain
- Neck pain (cervical pain)
- Restless leg syndrome
- Hip, knee, or leg pain
- Sciatica
- Fibromyalgia
- Migraines and headaches
- Temporomandibular joint disorder (TMJ)
- Peripheral neuropathy
- Diabetic nerve pain
- Cancer-related pain
- Shingles or postherpetic neuralgia
- Irritable bowel syndrome (IBS)
- Multiple sclerosis (MS)
- Post-surgical pain
- Herniated discs
- Spinal stenosis
- Pelvic pain
- Degenerative joint disease (DJD)
- Nerve injury
- Scar pain
- Musculoskeletal condition
These aren’t the only conditions that cause pain and sleep issues—many chronic conditions can interfere with restorative rest and significantly impact your quality of life if left untreated.
Break the Chronic Pain–No Sleep Cycle: Tips to Sleep Better
While there’s no one-size-fits-all solution, there are several things you can try that may help improve your sleep—even when you’re hurting:
Optimize Your Sleep Environment
- Your sleep space needs to reflect its use! Bedrooms should be clean, comfortable, and set up for sleep.
- Your bedroom should be strictly used for sleep and intimate activities. Don’t watch TVs or do other sleep-incompatible activities in your sleep space.
- Invest in a supportive mattress and pillow. Your bed should support your body, not make the pain worse. Consider a memory foam topper or a wedge pillow to relieve pressure in certain areas.
- Keep your room cool, quiet, and dark. Small changes like blackout curtains, a white noise machine, or a fan can make a big difference.
- Limit screen time before bed. The blue light from your phone or TV can mess with your sleep hormones, especially when you’re already sensitive to disturbances.
Establish a Bedtime Routine
- Your bedtime routine actually starts in the morning! Start your day out with these tips to improve your sleep-wake cycles.
- Go to bed and wake up at the same time every day. Yes, even on weekends.
- Wind down with calming activities. Try stretching, light reading, meditation, or a warm (not hot) bath to relax your body before sleep.
- Get enough sunlight early in the day. Morning sunshine helps regulate your internal time clock, which makes your body better at signaling sleep and wake times.
- Banish negative thoughts. Avoid worrying about pressing issues or your to-do list when you’re in bed.
- Pay attention to sleep signals. Hit the sack when your energy levels dip and you begin to feel sleepy. If you ignore your sleepiness, your body’s stress response can kick in with a surge of energy and alertness—making it nearly impossible to fall asleep until you’ve calmed down again.
Try Gentle Movement and Relaxation Techniques
- Light stretching or yoga before bed can help loosen tight muscles and calm your nervous system.
- Deep breathing or guided meditation can shift your focus from the pain and help your body feel safe enough to rest.
Time Your Pain Medication Wisely
If you take medication for your pain, ask your doctor whether you can adjust the timing so that it’s working when you’re trying to sleep. Some meds take time to kick in, so taking them too early—or too late—can affect your rest.
Note: If you suspect your pain medication is affecting your ability to sleep, speak to your doctor about your options.
Watch What You Eat and Drink
Caffeine, alcohol, and heavy meals too close to bedtime can all interfere with sleep and make inflammation worse.[4] Try to stick to lighter snacks in the evening and keep hydrated during the day.
The Importance of Seeing a Pain Management Specialist
Do you feel like you’ve exhausted all your tricks to get a good night’s sleep? If so, it may be time to talk to a pain specialist. These medical professionals are experts in how pain affects every part of your life—including your sleep. Together, your pain management team will create a personalized plan to help you feel better, day or night.
Pain management treatments can include targeted pain relief procedures like nerve blocks, scrambler therapy, or joint injections. Physical therapy and alternative options like acupuncture, massage, and chiropractic care can work together to relieve pain, improve mobility, and help you feel more like yourself. With pain under control, staying active during the day supports your physical and mental health—and sets the stage for better sleep at night.
Relief and better sleep are possible. The bottom line is, chronic pain may be messing with your sleep, but there are steps you can take to combat painsomnia. Start with small changes, stay consistent, and don’t hesitate to ask for help. A good night’s rest doesn’t have to be a pipe dream—it’s achievable with proper care and something you absolutely deserve.
Resources:
- McDermott-Murphy C. Headache or Sore All Over After Bad Night’s Sleep? The Harvard Gazette [Internet]. Published November 28, 2023. Accessed March 31, 2025. Available from: https://news.harvard.edu/gazette/story/2023/11/researchers-find-link-between-poor-sleep-and-chronic-pain/
- Whale K, Gooberman-Hill R. The Importance of Sleep for People With Chronic Pain: Current Insights and Evidence. JBMR Plus [Internet]. 2022;6(7):e10658. Published 2022 Jun 17. doi:10.1002/jbm4.10658. Accessed March 31, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9289983/
- Barrell A. Painsomnia: All You Need to Know. Medical News Today [Internet]. Published December 23, 2022. Accessed March 31, 2025. Available from: https://www.medicalnewstoday.com/articles/painsomnia
- How to Beat Insomnia When You Have Chronic Pain. Cleveland Clinic [Internet]. Published August 10, 2020. Accessed March 31, 2025. Available from: https://health.clevelandclinic.org/managing-insomnia-for-those-with-chronic-pain
