Health & Wellness Articles

Sleeping Soundly with Chronic Pain

7 Ways to Sleep Better Now

If you live with chronic pain, whether from pounding headaches, an autoimmune disorder or an old injury gone awry, you know how difficult it can be to get to sleep. And when you can’t rest, pain increases, making it harder and harder to break the cycle of escalating pain and sleeplessness.

Pain doesn’t just make it harder to fall asleep and stay asleep, but can also impact your quality of sleep. For example, you may sleep less efficiently, spending less time in the most restorative phases of sleep.
Yet sleep has so many health benefits beyond staving off pain. It helps the brain learn and remember new things, bolsters the immune system, keeps moods stable and reduces stress. ­­­­­­Restful sleep can even reduce the intensity and duration of pain. So, how can people with pain take charge of sleep? Try the tips below to take the stress out of bedtime and harness healthy ZZZs.

Adjust your pillow
If you have neck or back pain, sleeping on your stomach can exacerbate your problem because it causes your spine to arch and your neck to twist. Your sleeping position should take any health conditions (such as acid reflux) into account, so check with your physician before switching your routine.

Ready for a change? Body pillows can help reinforce a new sleeping position by preventing you from tossing and turning. If you have back pain, sleeping on your back with a pillow under your knees can take pressure off of the spine. Holding a body pillow between your knees can also prevent those bony joints from touching and help align your hips for greater comfort.

If you have neck pain, an orthopedic (contoured) pillow can help provide support. Remember that any time you sleep, your positioning is important, so consider a travel pillow if you have a long flight or if you plan to sleep while riding in the car.

Practice Mindfulness
If you have a hard time turning your attention away from pain while lying in bed,  remind yourself that a thought is just an idea; you don’t have to believe in it or act on it. Instead, try this simple, pain-reducing exercise:  
  • Set a timer for 5 minutes.
  • Find a comfortable position to lie down.
  • Focus on your lungs expanding and contracting as your breathe in and out for a few moments.
  • Put yourself in neutral frame of mind. It may help to imagine cares and worries from the day sailing or floating away.
  • Observe your thoughts without labeling them "good" or "bad."
  • If a negative thought ("This pain will never end" or "The pain is too awful, I can’t bear it") pops up, acknowledge it, then turn your attention back to your breathing.
We know that the brain and body are connected, and stress, depression and anxiety play a part in how we perceive pain. Try allowing yourself to experience these thoughts without embracing them to prime your body for healing, restorative sleep.

Relieve Muscle Tension
Carve out time in your schedule for pain-management techniques that work for you, such as a hot bath, an ice or heating pack or a few minutes of slow, even breathing. Regular relaxation rituals, such as calming music or aromatherapy (try lavender to aid sleep), relax aching muscles to break the cycle of pain and help you drift off to sleep more easily.

Get Strategic
Simple sleep hygiene, or the habits you follow around bedtime, can make a big difference in how well you sleep. When pain is bothersome, it can be easy to overlook these basics. But the fewer factors you have to contend with in addition to pain, the more likely you'll be able to fall asleep and stay asleep. Remember to:
  • Limit environmental noise or wear earplugs.
  • Make your bed a place for sleep and sex only, not work or screen media.
  • Go to bed and wake up at the same time each day (even on the weekends).
  • Avoid long naps, especially in the late afternoon and evening
  • Limit alcohol and caffeine intake in the hours before bed.
  • Exercise regularly, but avoid working out within three hours of your bedtime.
  • Limit time spent staring your computer, phone, TV or other screen before bed.
  • Don't share your bed--or your room--with pets, which can disrupt sleep.
Rethink Your Attitude
Thinking about pain frequently and dwelling on its negative effects on your life can make it harder to go to sleep. Scheduling a fun distraction, even something as simple as reading a favorite magazine, can take your mind off worrisome pain and make it easier to fall asleep.

Consider Supplements
Sleep-promoting supplements, such as melatonin, may help you get much-needed shut eye without a prescription. Gather information about how tiredness impacts your pain and daily activities and consult a healthcare provider to see if an over-the-counter product could help.

Rule Out Other Underlying Conditions
When pain is out of control, sleep may be impossible. Talk to your physician about your daily pain levels and how best to balance day-to-day function with pain relief. Ask specifically about pain that spikes around bedtime, and how you might use medications for nighttime pain relief (as compared to your during-the-day regimen) if appropriate.

Even a quick chat with a general practitioner during a routine physical can help by ruling out sleep-limiting conditions such as sleep apnea, and ensure that existing medications you may be taking aren't interfering with your sleep.

Chronic pain can have so many implications for daily life, but chronically poor sleep doesn’t have to be one of them. Some sleep loss may be inevitable on bad days, but practicing good sleep habits on a regular basis will help you break the cycle of poor sleep and increased pain, and keep overall pain levels manageable.

Boody, Elisa. "Lavender as a Sleep Aid," Vanderbilt University Psychology Department, accessed on April 22, 2013.

Edwards, Robert R., Almeida, David M., Klick, Brenda, Haythornthwaite, Jennifer A., Smith, Michael T. "Duration of Sleep Contributes to Next-Day Pain Report in General Population," PAIN, 2008 (202-207).
Harvard Medical School, "Importance of Sleep: Six Reasons Not to Scrimp on Sleep,", accessed on April 22, 2013.
Health Promotion and Wellness,"Sleep,", accessed on April 22, 2013.
Healthy Sleep, "Benefits of Sleep,", accessed on April 22, 2013.
International Association for the Study of Pain, "Chronic Pain Management: Measurement-Based Step Care Solutions," December 2012.
Plante, David T., Sewell, Andrew R., Price, Bruce H., Cunningham, Miles. "Sleep, Fatigue and Pain: The Triad of Functional Somatic Syndromes." McLean Annals of Behavioral Neurology, 2006, 1:1-9).
UC Health Line, "Certain Sleeping Positions Can Impact the Quality of Your Rest,", accessed on April 22, 2013.
University of Utah Health Care, "Adjusting Your Attitude about Chronic Pain May Help You Sleep,", accessed on April 22, 2013.
Zhdanova, Iran V., Lynch, Harry J., Wurtman, Richard J. "Melatonin: A Sleep-Promoting Hormone," American Sleep Disorders Association, July 1997, 899-907.

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Member Comments

  • Great information here. I have just registered for a 6 week course on living with severe pain. I'm looking forward to start attending next week. I can possibly relay some of this information to the class as well.
  • I actually sleep better with one or more of my cats on top of me especially when it is cold. They create a warm spot (body contact) and start purring and that can even have me falling asleep when I wasn't planning on it.
  • Darkness cannot drive out darkness;
    only light can do that.
    Hate cannot drive out hate;
    only love can do that.
    - Martin Luther King, Jr.
  • Thank you- something I really needed to hear.
  • I was glad to see I wasn't the only one who can't take melatonin - I feel like TOTAL crap the next day ( like almost HUNG OVER - NO Thanks) and then it takes a day or two to feel normal again. I can take Sleep MD (not sure if its available outside of Canada or Z-quil but I usually only take 1/2 of a dose). They usually don't seem to bother me - a couple of Gravol pills also works.
  • I feel groggy as well when so take Melatonin to sleep. A single Benadryl pill )which is the same ingredient of all the over the counter sleep aids like Tylenol PM or Advil PM) is what I take a few nights a week. I use 3 different thickness and firmness of pillows. One for under my head, one between my arms that is fluffy and soft and one between my knees that is thinner.
  • I have used melatonin several times. Never again!! I feel groggy when I wake up, and it also causes confusion. Now I just use a half of tylenol pm
  • Good information that I needed. Thank you!
  • I always have problems with my shoulder and arm. So I was up last night and tried the Melatonin no go but then tried a sleep aid a few hours later with some success. UGH... Never ever thought sleeping would be so hard for me...
  • I have three convoluted pillows that I bought at Kmart 30 years ago, I wash them, dry them first on the line, then in the dryer to kill dust mites. I cover them with two zippered special covers, then my pillowcase. I also have been sleeping with a pillow between my knees for almost 40 years. It relieves pressure on one's spine and neck. Trial and error are the best way to test what works for you.
  • Just need to find a real good pillow that will support my head and neck without going flat.
  • I have slept with a pillow between my knees for years and it really helps. My pillow is also a great pillow for neck and headaches.
  • Thanks for the tips!
  • Sigh. This article didn't help any.

About The Author

Robin Donovan Robin Donovan
Robin Donovan is a Cincinnati-based freelance writer and magazine journalist with experience covering health, medicine, science, business, technology and design.