Why Sleep Deprivation Worsens Pain: Chronic Pain and Sleep

If you live with chronic pain, you’ve likely noticed a frustrating pattern: the worse your pain, the harder it is to sleep; the less you sleep, the worse your pain feels. This isn’t just anecdotal. A growing body of research confirms that sleep deprivation and pain are deeply interconnected, creating a cycle that can be difficult to break.

This article will explain the connection between pain and sleep deprivation, and what you can do to help break out of this frustrating cycle. 

The Sleep–Pain Connection: What the Science Says

Sleep plays an essential role in regulating how the nervous system processes pain. With sleep deprivation, several changes happen in the body that can make pain more intense and harder to manage:

• Increased inflammation: Poor sleep promotes pro-inflammatory responses, which can heighten pain sensitivity.
• Reduced pain thresholds: Studies show that even partial sleep loss can lower pain tolerance, making minor discomforts feel more severe.
• Disrupted brain processing: Brain regions responsible for evaluating and modulating pain, like the thalamus and prefrontal cortex, become less effective when sleep deprived.
• Emotional stress: Fatigue increases emotional reactivity, which can worsen the experience of pain and reduce your ability to cope.
  

In fact, research suggests that poor sleep can predict the development and worsening of chronic pain over time (Finan et al., 2013; Haack et al., 2020).

Breaking the Cycle: How to Improve Sleep (and Reduce Pain)

Fortunately, there are strategies that can help improve sleep quality, even if pain is keeping you up. Here are some evidence-based ways to support better rest:

1. Practice Sleep Hygiene

Consistent sleep routines help regulate your body’s internal clock:

• Go to bed and wake up at the same time every day.
• Keep your bedroom dark, cool, and quiet.
• Avoid screens for at least 30 minutes before bed.

 

2. Use Stimulus Control

Only use your bed for sleep and intimacy. If you can’t fall asleep within 20 minutes, get up and do a quiet activity until you feel drowsy, this helps your brain re-learn the critical association: bed means sleep.

3. Reduce Caffeine and Alcohol

Both can disrupt sleep architecture, particularly the deep, restorative stages that help regulate pain.  

4. Mind-Body Strategies

Gentle relaxation techniques such as progressive muscle relaxation, mindfulness, or deep breathing can quiet the nervous system and reduce tension at bedtime.

5. Track and Reflect

Keeping a sleep diary can help you notice patterns and triggers. Our Sleep Diary Worksheet is one helpful tool to get started. 

A Resource for Building Better Sleep Habits

If you’re looking for a more structured way to improve your sleep, the free Sleep and Chronic Pain course from the I-Engage Academy offers practical, science-informed strategies, downloadable worksheets, and guided reflection exercises. You’ll learn how sleep works, why it matters for pain, and what you can do to take back control.

Conclusion

Improving sleep isn’t always easy, especially when pain is a daily reality. But even small changes to your sleep habits can have a meaningful impact over time. By supporting your sleep, you’re also supporting your body’s ability to heal, regulate pain, and build resilience.

References

• Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The association of sleep and pain: An update and a path forward. The Journal of Pain, 14(12), 1539–1552. https://doi.org/10.1016/j.jpain.2013.08.007 
• Haack, M., Simpson, N., Sethna, N., Kaur, S., & Mullington, J. (2020). Sleep deficiency and chronic pain: Potential underlying mechanisms and clinical implications. Neuropsychopharmacology, 45(1), 205–216. https://doi.org/10.1038/s41386-019-0439-z