Chronic Pain and Insomnia: What's the Connection?

Last updated: January 2023

The impact of chronic pain goes so much deeper than pain. Sleep pattern and quality of sleep are often affected. The combination of both chronic pain and insomnia can be devastating.

Living with daily, chronic pain leads to fatigue. This fatigue cannot be relieved when you cannot sleep well. We wanted to shed a light on this connection and explore how chronic pain and insomnia frequently exist together.

Painsomnia: defining a vicious cycle

Sleep deprivation and inflicting pain are two common types of torture. It is not hard to see why having these conditions at the same time leads to misery for the person living with both conditions.1

Painsomnia is a term created to describe this vicious cycle. A person who has chronic pain often seeks rest and sleep to help manage the daily pain. The irony is that those with chronic pain often have trouble falling and staying asleep. This disruptive sleep pattern worsens the person’s pain, increases fatigue, and the cycle starts all over again.2

Did pain or insomnia start first?

Which came first, chronic pain or insomnia? One study examined whether insomnia and decreased quality of sleep leads to chronic pain. The study started with individuals who were free from chronic pain. The people in the study had also reported insomnia symptoms and reported depression. The results showed that 11 percent of these people developed chronic pain over two years, 17 percent over four years, and 21 percent over 6 years.3

Although the subjects also reported baseline depression, these results suggest that chronic insomnia and disturbed sleep may be a major contributing factor to developing chronic pain.

Painsomnia and your overall health

Sleep quality and duration are linked to your overall health. Not getting enough sleep – or not getting good-quality, restful sleep – means you are more likely to have chronic pain. And the problems go both ways. Pain can keep you from sleeping well. And not sleeping well can:4,5

  • Increase your chances of experiencing pain
  • Lower your ability to put up with pain

The National Institutes of Health states "sleep is as important for good health as diet and exercise." At least one study has found that cognitive behavioral therapy for insomnia, or CBT-I, can also help with chronic pain.4,5

Tips for better sleep and pain relief

Getting good sleep when you have chronic pain is not easy. Experts say one of the best things you can do is make your sleep a priority. Life and daily tasks may keep you from bed, but making sure you get quality sleep is important.

Try using good sleep practices to get better sleep and cut down your pain. Keep track of what you try and how it works. Practices to improve sleep include:2

  • Keeping a consistent sleep schedule
  • Doing moderate exercise early – not late – in the day
  • Practicing relaxation, like meditation or deep breathing
  • Not using your bed for anything other than sleep and sex

Let your doctor know

Chances are, you have talked to your doctor about your sleep and your chronic pain. If you haven’t, now is the time. Your doctor can recommend treatment that is right for you and talking to your doctor is always a good idea when having trouble with your sleep.

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