Sleep and Chronic Pain: Why Quality Sleep Matters for Recovery

If you’re living with chronic pain, you know how difficult it can be to get a good night’s sleep. Pain can make it hard to fall asleep, difficult to stay asleep, and can leave you feeling exhausted the next day. Unfortunately, the relationship between sleep and chronic pain works both ways. Poor sleep can increase pain sensitivity, creating a cycle that is difficult to break.

I remember feeling like it was just me and my pain trying to unwind and relax, making it really difficult to relax and sleep. Difficulty sleeping is hard due to the pain, and when we don’t sleep, a lack of sleep can increase our pain because our body becomes exhausted. This cycle seems to repeat itself every night. Improving your sleep won’t eliminate your chronic pain overnight; however, it can improve your health, mood, healing, and strength.

Why Sleep Matters

Sleep is super important for the body because lots of things take place during this rest time. I find it amazing what goes on inside during the sleep and recovery phase of the body. Your truly amazing body is focusing on the following things.

The problem comes in when your body has trouble making the shift into the rest-and-digest phase, which slows down your breathing, relaxes your muscles, and your cortisol levels drop. When your body has trouble making this shift, that wired feeling kicks in, keeping the fight-or-flight active. You may have felt this when you feel your heart racing just when you are dozing off, or you wake up in the middle of the night between 1 and 3 am, feeling panicked, or you clench your jaw, grind your teeth, or tense up. Not shifting into this phase doesn’t give your body what it needs to recover. If you continue to have problems relaxing the nervous system, consider learning more about my 8 Week Nervous System Reset Program.

Tissue Repair: When you are in the deep stages of sleep, your body focuses on producing human growth hormones (HGH) and protein synthesis to help repair muscle, tissues, bones, and promote collagen production, bringing nutrients and blood supply to the areas that need them.

Hormone Regulation: Sleep is the hormone resetter for cortisol (stress hormone), melatonin (sleep hormone), leptin and ghrelin (hunger hormones), human growth hormone (repair and metabolism), and insulin (blood sugar) through the body’s natural circadian rhythm. When you do not get enough sleep, it disrupts this balance and can lead to increased stress, triggering overeating and insulin resistance.

Immune Function: Your immune function is bi-directional, consisting of a continuous communication between sleep and your immune system. When you sleep, your body produces immune-boosting proteins (cytokines) and cells to fight off pathogens. When you don’t sleep, your body produces fewer antibodies, increases inflammatory cytokines, which can lead to chronic inflammation, reduces the effectiveness of vaccines, and lowers your natural killer cells. Overall, this lowers your body’s defense system, making you more susceptible to illness and inflammation.

Pain Modulation: Sleep and pain are also bidirectional. When you don’t sleep well, your brain’s natural ability to lower your pain levels is impaired. On the opposite end, feeling pain during sleep creates a cycle of discomfort and exhaustion. When you don’t sleep well or achieve quality deep sleep, this blocks your brain’s ability to produce natural pain-killing responses and increases sensitivity, inflammation, and may even influence how some people respond to pain medications and how certain neurotransmitters are regulated, including dopamine and adenosine.

Memory: During deep sleep, our brain transfers our short-term memories into long-term storage. It also flushes out neurotoxins, strengthens neural connections, and is essential for learning, focus, and recall.

The Chronic Pain–Sleep Cycle

Lifestyle Factors That Affect Sleep

Many lifestyle habits influence sleep quality. Here are several that commonly affect people living with chronic pain.

Stress

Mental and physical stress have a high impact on sleep and being able to maintain the rest-and-digest mode over the fight-or-flight mode.

Caffeine

Drinking caffeine stimulates your nervous system, especially if you drink it in the afternoon.

Alcohol

You may think that alcohol is relaxing; however, even though it may help you fall asleep, it greatly reduces your quality of sleep.

Screens

The blue light from the T.V., cell phone, and computers actually stimulates your mind, making it more difficult to wind down

Irregular schedule

As I mentioned earlier, the light perceived by your eyes helps your brain create your sleep patterns, so going to bed at different times every day impacts that predetermined schedule.

Lack of movement

Regular activity often improves sleep because it wears your muscles and body down. If you don’t move, you can’t produce that sense of fatigue.

Healthy Sleep Habits

Developing healthy sleep habits is essential to achieve quality sleep. So focus on the following to make sure you’re supporting your sleep.

• Sleep Schedule – Create a consistent schedule where you go to bed and wake up at the same time each day.
• Make sure your bedroom is dark, blocking out light from electronics, windows, and the hallway.
• Make sure you feel comfortable in your bedroom. Your bed is comfortable, and the temperatures aren’t too cool or too warm.
• Limit caffeine and sugar consumption (preferably consume before noon) and avoid eating heavy meals after 6:00 pm. Your body naturally slows digestion down after 7:00 pm to support your body’s natural sleep cycle.
• Also reduce your screen time. I recommend shutting down the electronics 30 minutes prior to your bedtime and focusing on reading, gentle stretching, relaxation breathing, or meditation to create a bedtime relaxation ritual.
• If you are one of the individuals who needs some noise to relax and sleep, invest in a product that produces white noise; they are very effective.

Calming the Nervous System Before Bed

Relaxing your nervous system can promote better sleep. The following are several things you can try to help you do that. Some people also use tart cherry juice as part of their bedtime routine because it contains natural compounds that may support better sleep.

• Meditation offers many different options and is great for relaxation. Learn about the different types of meditation and how to get started.
• Gentle yoga is a very slow and mindful practice that focuses on gradual stretching, joint mobility, and breath connection without initiating strain on the body. It is great for beginners or individuals recovering from injuries. Here is a link to a video with Adrienne on Gentle Yoga.
• Prayer, journaling, and Practicing Gratitude are great ways to focus on hope, learning more about yourself, and focusing on what you have and what you can do.

When Pain Interrupts Sleep

If you wake up in the middle of the night because pain interrupted your sleep, try one of the following instead of becoming frustrated or mad. Remember that waking up occasionally is normal. The goal isn’t perfect sleep; it’s about learning to help your body relax enough to return to sleep more easily.

• Practice relaxation by deep breathing, meditating, or journaling.
• Do some gentle stretching.
• Change positions
• Use heat or cold packs. I find heat helps me relax.
• Don’t watch the clock
• Avoid catastrophizing

When to Talk to Your Healthcare Provider

If you are dealing with insomnia, sleep apnea, restless legs, severe fatigue, or are taking medications that may be affecting your sleep. Reach out to your healthcare provider for additional help.

My Perspective

Sleep definitely had an impact on my pain, and my pain had a definite impact on my sleep. During the day, I was often busy, so I didn’t think about it like I did when I went to wind down. Once I got to bed, it seemed like the pain was amplifying in my head, and I could feel the panic. So many of the tips I share with you, I actually do. My favorites were listening to relaxing music, grabbing my heat pad because the warmth seemed to help me relax, and I would always practice deep breathing. Utilizing those three things worked for me. As my sleep gradually improved, I noticed I handled pain, stress, and everyday life much better.

Key Takeaways

• Sleep and chronic pain influence each other.
• Better sleep supports healing, immune function, and nervous system balance.
• Small improvements in sleep habits can make a meaningful difference.
• Calming the nervous system before bed may improve sleep quality.
• Better sleep improves resilience, even if pain doesn’t disappear.

If you are looking for more information, visit our Living With Chronic Pain Learning Center.