Chronic pain affects many people, with 1 in 5 Australian adults over the age of 45 suffering from chronic pain. It represents an enormous burden for those suffering, as well as society overall (1).
Sleep and pain are two words that don’t play well together, with many people experiencing pain which worsens at night. This can especially be the case for people suffering from mild arthritis and mild osteoarthritis. When this happens, it can be difficult to fall asleep, and stay asleep. A study conducted in 2020 found that online searches for information about pain management peak between 11:00pm and 4:00am (2).
This highlights the number of people who lay awake at night, looking for ways to manage their pain and get a good night’s sleep!
People with chronic pain are more likely to be diagnosed with a sleep disorder, with 67-88% of people presenting with sleep complaints (3). For many, ‘painsomnia’ or difficulty sleeping caused by persistent pain is a common and dreaded issue.
Pain can affect sleep for a few different reasons. Some people may experience pain that worsens at night, some may have persistent pain throughout the day, or others may have pain that is affected by certain sleeping positions. This can lead to difficulty falling asleep, however the most common sleep complaint for people experiencing pain is waking frequently throughout the night (4).
The link between poor sleep and painful conditions such as arthritis has been established in many studies.
Consistent poor-quality sleep has been linked to a decrease in a person’s pain threshold, meaning poor sleep makes an individual less able to tolerate pain (5).
It is unclear exactly what can cause pain to worsen at night, however a 2019 study found a potential reason as to why pain worsens after a particularly bad nights sleep. The researchers demonstrated that sleep deprivation causes certain pain centres in the brain to be more active than they normally would be, amplifying the experience of pain (6).
This was reflected in a 2018 study which found that pain worsened after a bad night’s sleep, but improved after a particularly good night’s sleep (7).
The good news is that there are some steps you can take to help break the vicious cycle of poor sleep (8,9).