Sleep and pain have something in common: You need both to survive. But when these essential functions come into conflict, health and well-being can suffer. In fact, sleep and pain are locked in a complex dance: Pain makes it hard to sleep, while poor sleep can contribute to the development of chronic pain and impair your body’s ability to curb pain in general.
The connection between pain and sleeping
Whether it’s from arthritis, fibromyalgia, gout, back pain, headaches, menstrual cramps, an injury—or any of a million other reasons—more than half of Americans experience pain in any given week. Half of those with pain say it interferes with their sleep every day.
Pain during sleep can be frustrating—but pain medications also have a profound impact on sleep, as opioids disrupt the sleep cycle. Research shows that even over-the-counter pain meds such as ibuprofen and aspirin affect the sleep cycle. While pain meds may help you sleep in the short-term, they often do more harm than good in the long run.
The National Sleep Foundation’s 2015 “Sleep in America” Poll found that:
- 21% of the 1,029 participating adults had chronic pain.
- 36% experienced acute pain in the previous week.
- Only 46% of those with acute pain and 36% of those with chronic pain reported good or very good sleep quality—compared with 65% of those without pain.
- Those with chronic pain experienced an average “sleep debt” of 42 minutes. (Sleep debt is the difference between the amount of sleep you need and the amount of sleep you’re actually getting.)
- Those with acute pain in the past week experienced an average sleep debt of 14 minutes.
- Sleep disturbance, and pain, tend to increase with age.
- African-Americans exhibit worse sleep impairments and greater pain sensitivity than Caucasians.
- Females exhibit worse sleep impairments and greater pain sensitivity than males.
Studies described in a Journal of Pain review show a reciprocal relationship between sleep disturbances, such as insomnia symptoms, and clinical pain reports. The review likewise notes other research findings that insomnia symptoms significantly increase the risk of developing future chronic pain disorders in previously pain-free individuals.
How to sleep better while in pain
The good news is that you don’t have to give up on getting a good night’s sleep even if you have chronic pain.
There are a number of ways to manage pain, and master sleep management, while you’re at it. Here are a few expert recommendations for sleeping soundly with various types of pain:
Use pillows strategically. Some kinds of pain, such as back and neck pain, are made worse by awkward sleeping positions. Sleeping on your stomach, for example, can exacerbate back pain and neck pain because it throws your spine out of alignment and forces you to sleep with your head twisted to one side.
Relieve back pressure by sleeping on your back with a pillow under your knees, or on your side with a pillow between your knees. You can reduce neck pain with an orthopedic (contoured) pillow. Keeping your spine properly aligned is the most important thing you can do to find relief and help you sleep. (Here are some more tips for sleeping better with back pain.)
Practice relaxation. You can modulate pain with a hot bath, ice pack, heating pad, calming music, or aromatherapy (lavender is widely recommended for its well-known calming effect). Relaxation rituals can train your body to be ready for sleep. (Try these 10 nighttime activities to help you relax.)
Consider an adjustable bed frame. It can be nearly impossible to find a comfortable position when your chronic pain is flaring. An adjustable bed frame lets you raise or lower your head, feet, or both, to find the best angle and position for your body. It’s not coincidental that hospitals use adjustable bed frames—they’re good for your health, and also good for your life.
Use noise-canceling headphones. They block out sound so you aren’t awakened by every bump in the night and also allow you to put on music or something else that can distract you from your pain and help you fall asleep.
Top your mattress with memory foam. An overly firm mattress puts pressure on sore muscles and joints. If you have pain when falling asleep, a mattress topper is worth looking into. A memory foam topper specifically can add a layer of cushioning and softness. (Memory foam mattresses, like Saatva’s Loom & Leaf, are frequently recommended by chiropractors for their pressure-relieving abilities.)
Apply a hot or cold rice pack or a heating pad. You can either microwave or freeze a rice pack, depending on whether you want hot or cold therapy, and apply it to parts of your body affected by chronic pain. If you have osteoarthritis, applying a heating pad 15 or 20 minutes before bed can have the same soothing effect as a warm bath and offer the pain relief you need for a good night’s sleep.
Exercise and stretch. That will help keep joints from stiffening and increase the range of motion in arthritic joints. If you have fibromyalgia or restless leg syndrome, it’s important to exercise during the daytime because working out too close to bedtime could leave you too wound up to fall asleep. (Here’s a morning yoga routine to energize your body when you wake up.)
Tailor your medication time. Don’t wait until bedtime to take medications for restless leg syndrome, which affects half of people with fibromyalgia, if you know they tend to keep you awake. Alcohol, caffeine, and nicotine are also known to worsen RLS symptoms.
Why you should make sleep a priority, especially if you have pain
Americans who say they have very good or excellent health and quality of life report sleeping 18 to 23 minutes longer, on average, in the past week than those who rate their health and quality of life as just good, fair, or poor.
Yet the National Sleep Foundation’s 2018 Sleep in America poll found that only 10% of American adults prioritize their sleep over other aspects of daily living, such as fitness, nutrition, work, social life, hobbies, and personal interests.
But making sleep a priority can have a positive impact on your health, especially if you’re living with pain.
“Taking control of your sleep by being motivated, setting a routine at bedtime, and creating a supportive sleep environment are relevant even for those with pain,” said David Cloud, CEO of the National Sleep Foundation in a statement. “Sleep is a key marker of health, and good sleep habits are critical for improving the quality of life of those living with chronic or acute pain.”