How can pain affect my sleep?

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Chronic pain and sleeping problems can often create a vicious circle, where being in pain makes sleep difficult and a lack of sleep increases the experience of pain.

vicious cycle of pain and sleep

Not getting enough sleep has many negative impacts on your life. It can affect your memory, concentration and attention. It can occur for many reasons, but we will explore the reasons commonly experienced by people with chronic pain.

Insomnia

You have probably heard the word "insomnia" before. Insomnia means "no sleep" in Latin, and is one of the most common sleep complaints in teens and adults.

Almost everyone has experienced insomnia at some point. Maybe you have had problems falling asleep before an important exam or job interview, or maybe you had trouble sleeping when you were too excited before or after a fun event.

Insomnia can be a short-lived problem related to a stressful event in your life, but it can also be a long-term problem that persists for many nights, sometimes weeks on end.

The signs and symptoms of insomnia include:

  • difficulty falling asleep
  • difficulty staying asleep
  • waking up too early and being unable to get back to sleep
  • not feeling well rested in the morning after having a shower or starting to move around
  • feeling that poor sleep is causing problems during the day.

What can cause insomnia?

Many different factors can contribute to having insomnia. For example, a person with chronic pain may have started having some insomnia because pain interfered with getting comfortable enough to fall asleep or stay asleep. A person with chronic pain may also have insomnia because of poor sleep habits such as consuming too much caffeine, spending too much time in bed napping during the day or not having a regular bedtime and wake time. Other causes of insomnia can be negative thoughts, as described in the next section.

How can my thoughts affect my insomnia?

Negative thoughts, such as, "I will not be able to fall asleep tonight and won’t be able to function tomorrow" can actually prevent you from comfortably settling down to sleep. It is important to know what you are thinking about your sleep because negative thoughts can increase your distress and make it harder to sleep well.

Here are some examples of negative or unhelpful thoughts.

  • "I've lost the ability to sleep like a normal person."
  • "I won't be able to go to school or work tomorrow if I don't sleep well."
  • "If I don’t sleep tonight, I’ll have to sleep-in tomorrow or take a nap during the day."
  • “If I don’t get nine hours of sleep tonight, I won’t be able to function tomorrow."

Many people develop insomnia because they have learned to associate their bedroom with negative thoughts or worries about not being able to fall asleep or with being tense or anxious before falling asleep. Insomnia is usually something that is learned, much like a bad habit. Just like any bad habit, however, it can be changed with time and practice.

Insomnia survey

Think about the following questions:

  • Do you feel sleepier in the living room on the sofa than in your own bedroom?
  • Do you dread the thought of going to bed?
  • Do you sleep better when you are away from home?
  • Do you feel tense, alert or anxious in bed even when you know you are tired?
  • Do you stay in bed no matter how long it takes to fall asleep?
  • Do you hate the sight of your alarm clock?
  • Do you wake up at similar times during the night or early morning?
  • Does your mind suddenly become active or wide awake when you get into bed or when you wake up during the night?

If you answered "yes" to any of these questions, there is a good chance that you might have learned some habits that make it difficult for you to fall asleep or to stay asleep during the night. These habits can increase your chances of developing insomnia.

If your sleep problems persist over time, your doctor may recommend that you take part in a sleep study to find out what is happening and rule out other potential causes. You can find out more about sleep studies and what they involve from the American Academy of Sleep Medicine and the National Sleep Foundation​.

Last updated: May 2nd 2016