Pain And Sleep: Breaking The Vicious Cycle

  • Sichen Yin Msc, in Clinical Neuropsychiatry, King’s College London

Pain and sleep are two of life's most fundamental components, and they're linked in a complex and often vicious cycle. We've all experienced the torment of sleepless nights due to pain, and chronic pain and sleep disorders affect millions of individuals' well-being. 

It’s important to understand the relationship between the two.

In this article, we will explore how pain disrupts sleep and how poor sleep can exacerbate pain and advise on improving the quality of life for those enduring this challenging vicious cycle.

The pain-sleep connection

Pain and sleep are closely intertwined. Pain can make it difficult to sleep, and conversely, poor sleep can exacerbate pain. 

Pain disrupting sleep

  1. Physical Discomfort: When in pain, falling asleep and staying asleep can be a difficult task. Pain keeps the mind awake, making it hard to relax and find a comfortable sleeping position. Conditions like arthritis, fibromyalgia, and back pain can be particularly disruptive to sleep, leading to frequent awakenings during the night.1
  2. Mental Distress: Pain often leads to increased stress and anxiety, further hindering sleep.2

Poor sleep exacerbates pain

  1. Sensitivity to Pain: A lack of quality sleep can increase an individual's sensitivity to pain. During deep sleep, the body engages in healing and restorative processes. When these processes are disrupted, the perception of pain intensifies.3
  2. Reduced Pain Tolerance: Poor sleep impairs the body's ability to tolerate pain. This means that individuals with chronic pain conditions may find their discomfort harder to bear when they haven't slept well.4   

The consequences of the vicious cycle

The pain-sleep cycle can lead to numerous detrimental consequences, affecting both physical and mental well-being.

Physical consequences

  1. Weakened Immune System: Prolonged sleep deprivation weakens the immune system, making individuals more susceptible to infections and illnesses. For those already dealing with chronic pain, the added burden of frequent illnesses can exacerbate their condition.5
  2. Impaired Cognitive Function: Lack of sleep impairs cognitive function, leading to difficulties in concentration, memory, and decision-making. This can affect a person's ability to work, engage in social activities, or simply enjoy life.6
  3. Weight Gain: Poor sleep patterns are associated with weight gain and obesity. An unhealthy weight can further intensify the physical burden of chronic pain conditions.7

Psychological consequences

  1. Mood Disturbances: The relentless pain-sleep cycle can lead to mood disturbances, including anxiety and depression. The emotional impact of living with pain and sleep deprivation is substantial.8
  2. Reduced Quality of Life: When individuals are trapped in this cycle, their overall quality of life deteriorates. They may miss out on important life events, social interactions, and activities they once enjoyed.9
  3. Strained Relationships: Chronic pain and sleep disturbances can strain relationships with family and friends. The lack of sleep can make individuals irritable and less able to cope with everyday stressors.

Breaking the vicious cycle

The good news is that there are strategies and interventions available to help break the pain-sleep cycle. Here are some practical steps to consider:

Medical intervention

  1. Consult a Healthcare Professional: If you are experiencing chronic pain and sleep disturbances, it's essential to consult a healthcare professional. They can diagnose the underlying causes of your pain and suggest appropriate treatments, which may include medications, physical therapy, or surgical options.
  2. Sleep Evaluation: Seek out a sleep specialist who can assess your sleep patterns and recommend treatments for sleep disorders such as insomnia or sleep apnea.10
  3. Medication: In some cases, medications may be prescribed to manage pain and improve sleep. It's important to discuss the potential benefits and risks with your healthcare provider.11

Behavioural interventions

  1. Cognitive Behavioral Therapy (CBT): CBT is a widely recognized therapy for pain and sleep disorders. It can help individuals manage pain perception, reduce anxiety and stress related to pain, and improve sleep hygiene.123
  2. Sleep Hygiene: Adopting good sleep habits can significantly improve the quality of your sleep. These habits include maintaining a regular sleep schedule, creating a comfortable sleep environment, and limiting caffeine and alcohol intake, especially in the evening.
  3. Pain Management Techniques: Learning to manage pain through relaxation techniques, mindfulness, or biofeedback can help reduce pain perception and improve sleep quality.

Lifestyle changes

  1. Physical Activity: Regular physical activity can help improve both pain and sleep. Low-impact exercises, such as swimming or yoga, can be particularly beneficial for those with chronic pain. Always remember to start with small amounts of any new exercise and slowly increase as your pain and energy allow.
  2. Dietary Adjustments: A healthy diet can play a crucial role in managing pain and improving sleep. Reducing inflammatory foods and maintaining a balanced diet can have a positive impact.
  3. Stress Reduction: Practices like meditation, deep breathing, or progressive muscle relaxation can help reduce stress and anxiety, making it easier to fall asleep.

Support and coping strategies

Dealing with chronic pain and sleep disturbances can be isolating and emotionally taxing. Here are some support and coping strategies:

  1. Support Groups: Joining a support group for individuals with chronic pain can provide a sense of community and understanding. Sharing experiences and coping strategies with others who face similar challenges can be incredibly helpful. It can help to feel that you are not alone in this pain and sleepless battle.
  2. Open Communication: Talk to your friends and family about your condition. It's important for them to understand what you're going through, and their support can make a significant difference in your life.
  3. Mindfulness and Acceptance: Learning to accept your condition while actively seeking ways to improve it can reduce the emotional burden of chronic pain.


In the labyrinth of pain and sleep, where each night can feel like a battle, and each day a weary trudge, the quest to break the vicious cycle is a pursuit of hope and healing. As we conclude this exploration, let us extend a hand to those navigating this challenging journey.

In the heart of pain and sleep disturbances, resilience is found. Each sleepless night, every moment of discomfort, bears witness to a strength that defies the odds. Breaking free from the grip of the pain-sleep cycle is not just a possibility; it's a journey marked by small victories, collective support, and the unwavering spirit to reclaim restful nights and brighter days.

May this article be a source of understanding and empathy for those facing the silent struggles of pain and sleep disruption? Together, let us foster an environment where stories are shared and where the shared strength of the human spirit becomes a beacon of hope. As we acknowledge the challenges, may we also embrace the possibility of healing, recognizing that each step towards better sleep is a step towards restored well-being.


  1.  Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. *Sleep Medicine Reviews*.
  2. Moldofsky H. The significance, assessment, and management of nonrestorative sleep in fibromyalgia syndrome. *CNS Spectrums*.
  3. Lautenbacher S, Kundermann B, Krieg JC. Sleep deprivation and pain perception. *Sleep Medicine Reviews*.
  4. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. *The Journal of Pain*.
  5. Irwin MR. Sleep and inflammation: partners in sickness and in health. *Nature Reviews Immunology*.
  6. Dzaja A, Arber S, Hislop J, et al. Women's sleep in health and disease. *Journal of Psychiatric Research*.
  7. Smith MT, Perlis ML, Smith MS, Giles DE, Carmody TP. Sleep quality and presleep arousal in chronic pain. *Journal of Behavioral Medicine*.
  8. Tang NKY, Wright KJ, Salkovskis PM. Prevalence and correlates of clinical insomnia co-occurring with chronic back pain. *Journal of Sleep Research*.
  9. The National Sleep Foundation. Sleep and Mood.
  10. Sleep Foundation. When to See a Sleep Specialist.
  11. Harvard Health Publishing. Pain-relief options when you're in a bind.
  12. American Psychological Association. Cognitive-Behavioral Therapy for Chronic Pain.
  13. Cleveland Clinic. Sleep Hygiene.
  14. Cleveland Clinic. Biofeedback for Pain Management.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Sarah Engelbrecht

BSc Physio (Hons), University of Cape Town, South Africa

Sarah Engelbrecht is a practicing physiotherapist, who qualified in 2003. She has many years of experience in healthcare and helping patients with their health, fitness, and wellness. Her writing has been featured on various websites in the UK and the US. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles. 
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