How pain impacts sleep

By Lisa Ann Smalls

Pain and sleep are two vital functions our bodies need to work effectively. Pain lets us know something is wrong somewhere in our system. Sleep gives or bodies the chance to restore and revitalize itself. The problem when pain impacts sleep is that it can become a vicious cycle – chronic pain can lead to a sleep debt, and not enough sleep can make pain worse.

The problem with pain and sleep

People with pain experience disruptions to sleep that are 80 percent worse than the rest of the population. Unsurprisingly, pain can make it difficult to fall asleep as well as stay asleep. According to a poll conducted by the National Sleep Foundation, people suffering from chronic pain have a sleep debt of 42 minutes each night due to their pain, and people with acute pain have a sleep debt of 14 minutes per night. Over time, this sleep debt accrues. It can exacerbate a person’s pain, wreak havoc with their immune system, and even increase their risk of other chronic conditions, like obesity, heart disease, and diabetes.

Why does pain increase at night?

For starters, at night, there are fewer distractions from pain. A person with pain who may be able to distract themselves with activities during the day—as they try to quiet down their mind and body at night—may suddenly be more aware of the painful symptoms they’ve been avoiding all day.

Hormones may play a role as well. Our bodies run on a 24-hour cycle called the circadian rhythm. This rhythm dictates the fluctuations in our bodies’ chemicals and hormones. One of the hormones that drop at night is cortisol. Made by our adrenal glands, cortisol regulates blood pressure, reduces inflammation, and helps us manage stress. As cortisol drops, our white blood cells get to work fighting infections in our body, which can cause symptoms of infection or painful conditions to surface.

Research is ongoing into the link between sleep and pain and their impact on each other, with some showing a greater connection between cognitive arousal and sleep than pain and sleep – even for chronic pain sufferers.

How to promote better sleep

Making sleep a priority is the first step to improving your night’s rest. Even among those with pain, a greater motivation to get sleep was linked with longer sleep periods and better quality sleeping.

Making sure your mattress is supportive and comfortable is key. There is no “one size fits all”when it comes to the best mattress for pain. However, it is worth noting that a study done in 2003 looked at the firmness of mattresses for non-specific, low-back pain with results showing a medium-firm mattresses to be better than something that was extra-firm.

Stress reduction techniques such as mindfulness or meditation, can help prepare both the mind and body for sleep, triggering a relaxation response that help us to fall asleep and stay asleep for longer.

Just as exercise can help you manage pain, it can also aid sleep at night by decreasing arousal, anxiety and positively supporting circadian rhythms. Try to keep exercise to two or more hours before bed however, as if less, it can disrupt sleep.

Other “sleep hygiene” tips include creating a dark, quiet space using eye masks or earplugs; setting the temperature to the optimal 60-67* for sleeping; and setting a regular bedtime and wake up time to create a more standard routine.

Remember—sleep is vital to pain control! Prioritize your rest.

Lisa Smalls is a freelance writer from North Carolina who regularly covers the topic of sleep health. After seeing her mother, who was diagnosed with fibromyalgia in 2014, struggle to get adequate sleep due to the chronic pain she experienced as a result of her condition, Lisa became passionate about understanding the relationship between pain and sleep health. Now she loves educating others on the topic through her writing.