How to Sleep Better with Chronic Pain

Lack of sleep leads to an increased perception of pain. But also, chronic pain keeps you from sleeping. It’s a vicious cycle. And a common one, too. According to the National Sleep Foundation, chronic pain disturbs the sleep of one in five Americans at least a few nights per week.¹ But you can start to break the vicious circle of pain and insomnia by maintaining sleep-friendly behaviors, known as sleep hygiene.

“For chronic pain conditions, what you need is good sleep habits from the beginning—things that will last,” says Dr. Padma Gulur, a pain medicine specialist at Harvard-affiliated Massachusetts General Hospital.² That means relying on the brain’s natural sleep drive as much as possible, rather than medicating with sleep aids or pain relievers.

Whether from a bad back, arthritis, nerve damage, or headaches, chronic pain robs you of restful sleep and makes you more fatigued. And when you’re more fatigued, you are more sensitive to pain. “When you lose the restorative sleep, it enhances your subjective perception of pain,” Dr. Gulur says.

Use Relaxing Distraction to Get to Sleep

During the day, people with chronic pain can manage with activities that take the mind’s focus off the pain. But when they lie down to go to sleep, the lack of distraction can make the underlying pain more noticeable.

Dr. Gulur tells her patients to use “relaxing distraction” to get to sleep. First try meditation, visualization, or whatever relaxing distraction you favor. This can come in the form of widely available audio apps. Some teach basic rhythmic breathing meditation. Others focus on guided imagery, in which you imagine being in a calm, relaxing location. Find something that appeals to you and helps you fall asleep. Group or individual training and sleep education is also available.

But if it doesn’t work, getting up to read a book in a quiet room with low light can help you to get back to sleep. Avoid loud sounds and bright lights, like watching TV or a video. “Do things that are mind-numbing to you, like organizing the sock drawer,” Dr. Gulur says. “The next thing you know, you will go back to bed and want to sleep.”

Stay on a Regular Sleep Schedule

Staying on a regular sleep schedule is also highly recommended. Go to bed at the same time every night, and get up the next day at the same time. Stay awake until your next planned sleep time. This helps to set your internal sleep clock.

Avoid Sleep Drugs

Ideally, sleep medications should be used for temporary relief of insomnia. “Every time you take medication to sleep, you are actually taking away the body’s intrinsic ability to shut down and fall asleep,” Dr. Gulur says.

Get a Comfortable Bed

Proper form and comfortable support are key to minimizing discomfort while laying in bed. For example, a mattress that’s too firm may raise your hips, or a mattress that’s too soft may lower your hips. This may make your spine curve in an unnatural way and pinch your nerves. Pinched nerves can not only be painful, but over time may lead to nerve damage, as well.

Takeaway

Sleep hygiene is important for creating healthy sleep patterns so you can regularly get restorative sleep. Without enough sleep, fatigue can increase your perception of pain.