Sleep problems are very common among people with chronic pain. The connection between pain and sleep goes both ways: pain can disturb sleep, and poor sleep can worsen the experience of pain. This negative spiral can be difficult to break and has a significant impact on quality of life.

Chronic pain makes it difficult to fall asleep and to stay asleep through the night. Many wake up repeatedly due to pain when changing position or when pain medication stops working. Pain can also disrupt the deep sleep phases that are important for the body’s recovery and healing. Even if one sleeps for enough hours, the quality of sleep may be so poor that one wakes up tired and unrefreshed.

Poor sleep worsens the experience of pain in several ways. Lack of sleep lowers the pain threshold, making one more sensitive to painful stimuli. It also affects the body’s ability to regulate inflammation and stress, which can increase the intensity of pain. Many also experience that fatigue and exhaustion make it harder to cope with the emotional and daily challenges caused by pain.

Sleep problems in people with chronic pain may also include sleep apnea, restless legs, or nightmares. Anxiety and worries about the pain and its consequences can further disturb sleep at night. Many develop sleep anxiety, where the fear of another bad night’s sleep itself makes it difficult to relax and fall asleep.