Insomnia Caused by Chronic Pain: Some Help and Advice

Chronic pain can prevent you from falling asleep and staying asleep. This, in turn, intensifies the pain. What's the cause of this relationship and what can you do about it?
Insomnia Caused by Chronic Pain: Some Help and Advice

Last update: 25 August, 2021

Pain is one of the most unpleasant, annoying, and distressing sensations that you can ever experience. It makes you worry, is an obstacle in carrying out your daily tasks, and affects your social life. However, above all, it stops you from having a good night’s rest. Indeed, when pain is prolonged, your sleep is badly affected. In this article, we’re going to talk about insomnia caused by chronic pain.

If at some point in your life you’ve suffered significant pain, you may well have found yourself fearing the arrival of nighttime. That’s because the sensations of pain tend to be exacerbated by a lack of external stimuli. Hence, you’re unable to fall asleep, making you feel extremely frustrated. For those who suffer chronic pain, this is a constant in their daily life. And, although there may be methods to alleviate the pain, it’s always important to ensure that their quality of sleep is good.

Woman with insomnia from chronic pain

Chronic pain

Pain can manifest itself in two different ways. Acute pain arises in relation to a recent injury or problem, is of limited duration, and disappears as your body heals. On the other hand, chronic pain continues for more than three months or remains for one month after the original disorder has resolved itself.

Depending on its origin, chronic pain may manifest itself as dull or throbbing pain, pressure, or stiffness, among others. In addition, there are a variety of disorders that can lead to its appearance. The most common are:

  • Arthritis, osteoarthritis, and rheumatism.
  • Migraines and headaches.
  • Cancer.
  • Nerve damage
  • Fibromyalgia
  • Trauma and infections.

In general, it’s estimated that between 20 percent and 35 percent of the world’s population suffers from chronic pain. The personal and financial costs derived from this reality merit investment in research.

How does pain affect sleep?

Insomnia is just one of the consequences of chronic pain. It’s been discovered that around 50-89 percent of people with chronic pain experience sleep disorders as well as poor quality of life.

Insomnia related to chronic pain mainly manifests itself in difficulties falling asleep, frequent nocturnal awakenings due to pain, fragmented and poorly restorative sleep, and early awakenings.

Furthermore, it’s important to note that the relationship between rest and pain works in two ways. Pain prevents the person from resting properly. However, sleep deprivation exacerbates their perception of painful sensations. In this way, a vicious circle is generated that’s difficult to break.

Furthermore, when sleep isn’t complete, deep, and restorative, drugs used to mitigate pain lose their effectiveness. This is because the suppression of the REM phase of sleep causes the antalgic action of morphine and other opioids to be reduced.

Paradoxically, these same drugs can alter the structure of sleep and contribute to the suppression of the REM phase, causing increased sensitivity to pain. Ultimately, all these interactions place people with chronic pain in a really difficult situation.

What can be done?

Unfortunately, in many cases, it’s simply not possible to prevent the onset of chronic pain. For example, take the case of migraine. Although there are several approved preventive medications for this condition, they’re not always as effective as you might expect.

In contrast with other illnesses, drugs are only prescribed for pain management once it’s already appeared. Hence we ask the question, what can be done so that these sensations don’t interfere so badly with rest? There are several measures:

It’s been found that using drugs with delayed-release action can be more effective than those with a rapid release. This avoids the appearance of sleep disorders associated with painkillers.


Sleep hygiene

It’s essential that the person maintains adequate sleep hygiene. These simple steps can help them fall asleep, stay asleep and improve the quality of their rest. Steps to follow include:

  • Avoid drinking coffee, tea, sugar, and other stimulants in the late afternoon. Similarly, try not to drink alcohol as this can cause early awakening.
  • Take a warm bath or shower before bed. This can help relieve pain and induce a state of relaxation that encourages sleep.
  • Make sure that the environmental conditions are adequate. Darkness, silence, and a temperature of around 21 degrees are recommended.
  • Avoid doing anything other than resting in bed. For example, don’t eat or watch television.
  • Adopt stable sleep routines and stick with them every day, even on weekends. Also, try to go to bed at around 11 or 12 at night since this is the most favorable time for the body.

Ultimately, insomnia caused by chronic pain is difficult to prevent and manage. However, there are some solutions. In fact, if you suffer from this type of problem, don’t hesitate to mention it to your doctor so they can help you. Indeed, quality sleep is essential for your physical and psychological well-being. Therefore, you must always take care of it as much as possible.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Mencías Hurtado, A. B., & Rodríguez Hernández, J. L. (2012). Trastornos del sueño en el paciente con dolor crónico. Revista de la Sociedad Española del Dolor19(6), 332-334.
  • Covarrubias-Gómez, A., Guevara-López, U. M., Betancourt-Sandoval, J. A., Delgado-Carlo, M. M., Cardona-Cordero, A. V., & Hernández-Martínez, J. R. (2005). Evaluación del sueño en el dolor crónico no maligno. Rev Mex Anestesiol28(3), 130-8.
  • Perlis, M. L., Jungquist, C., Smith, M. T., & Posner, D. (2006). Cognitive behavioral treatment of insomnia: A session-by-session guide (Vol. 1). Springer Science & Business Media.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.