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Sleep and Pain

Medically reviewed by Smita Patel, DO, Susan Kerrigan, MD and Marianne Madsen on January 11, 2023

When you consider the connection between sleep and pain, you likely think about how pain keeps you awake. Yet there is another connection you may not have considered. Getting enough sleep at night can actually ease your pain during the day. So what are the links between pain and sleep? Just as importantly, what are the best ways to manage them?


Sleep Debt


A few years ago, an Oxford professor captured headlines by claiming that lack of sleep was as deadly as smoking. While some may quibble with neuroscientist Russell Foster’s comparison, there’s no question that insufficient sleep has been linked to heart disease, diabetes, and an increased risk of stroke. Because your body releases a hormone called ghrelin that triggers an almost overwhelming craving for food whenever you are tired, exhaustion has also been connected to obesity. For these reasons and many more, a healthy adult requires at least seven hours of sleep every night. If you’re recovering from surgery, battling cancer, or otherwise in impaired health you likely need considerably more. 


Unfortunately for chronic pain sufferers, sleep deprivation is quite common. One study suggested that 20% of adults suffer from chronic pain, with most of them also enduring substandard sleep. Chronic pain is pain that endures for more than three months –– such as persistent lower back pain, headaches, arthritis, or as the result of cancer. Acute pain, which can also affect sleep, is pain that is short term and transitory such as that suffered from a broken bone or a muscle sprain. Ironically many of the medications prescribed for pain management –– including ones designed to induce sleep –– can affect the quality of your slumber.


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Effects of Sleep Deprivation

Effects of Sleep Deprivation

Getting Better Sleep


If your sleep is interrupted frequently or is of low quality or quantity, you should start by taking a good look at your mattress. One study suggested that people with serious back pain reported improvements in sleep following the purchase of a new, medium-firm bedding system. Your sleep position is equally important. If you have back pain, sleeping on your stomach is a bad idea. Lying flat on your back can aggravate the condition as well. For most, side sleeping is ideal –– often with a pillow between your knees for optimum comfort. However, if you are battling knee or hip pain, then sleeping on your back may provide some measure of relief.


Melatonin, a naturally occurring hormone that regulates our sleep, has been shown in supplement form to improve the quality and quantity of sleep for some users. Recent studies suggest it is also effective at reducing inflammatory pain as well. Vitamin D, which our body produces naturally when exposed to sunlight, has also proven beneficial. If you’re blessed with a warm sunny day, some outdoor time can soothe aches and pains while improving that night’s sleep. One study even demonstrated how sleep and pain are intricately connected, not only because pain can affect the quality of your sleep but because when you are not well-rested your pain will actually feel more severe. 


The best advice for improving your sleep if you have issues with pain applies to everyone. If you can do some form of moderate activity during the day like walking or swimming, it can really help you sleep at night. Make your bedroom a space dedicated to sleep or sexual activity. Don’t make it a TV room or a home office. Keep it cool and dark. At least six hours before bedtime, restrict alcohol and caffeine. Read a book in another room, sip herbal tea, and/or have a hot bath or shower.  Create a routine that tells your body “It’s time to sleep!” and follow it. If you have trouble falling asleep, avoid tossing and turning. Instead, get up, go to another room and engage in a restful activity which takes your mind off of your pain. You can also try meditation or guided relaxation exercises.


Written by John Bankston

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