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Chronic Pain and Sleep

Those with chronic pain often report difficulty getting to sleep or maintaining sleep throughout the night. Unfortunately, a lack of sleep increases pain because sleep is important to recovery. This starts a cycle of pain, poor sleep, poor recovery, more pain, worse sleep, and so on. But some behavior changes can help you get to sleep and stay asleep! Read on to learn more.

Cycle of sleep and pain

Let's first understand the problem before we talk more about solutions.  

Pain can cause anxiety at bedtime, restless, and discomfort. This can lead to sleeping for a short amount of time and waking up often - resulting in poor sleep. 


Poor sleep can cause a lack of recovery, fatigue or tiredness, low mood (sadness, anxiety, frustration), and increased stress. This results in increased sensitivity to pain, the inability to deal with daily tasks and ultimately experiencing increased levels of pain. 

Check out the image on the right to better understand the cycle of poor sleep and chronic pain. 

Keep reading for some tips on how to improve your sleep. 


Improving sleep

Improving sleep can help you feel a lot better. Discussing sleep concerns with your doctor may assist in the diagnosis and management of underlying sleep disorders (example: obstructive sleep apnea).

Addressing behaviors, thoughts, and the environment associated with sleep, can help improve sleep over time and make you feel less pain. Check out this handout on sleep hygiene for tips on betting better sleep.

We've summarized some helpful tips on the right from the Centre for Clinical Interventions. 


Sleeping tips


Get regular. Try to go to bed and wake up at the same hour.

Sleep when sleepy. Only try to sleep when you get tired, instead of laying awake in bed. 

Get up and try again. If you can't sleep after 20 minutes of trying, get up and go do something calming. Then try again when you feel sleepy. 

Avoid caffeine and nicotine.  Don't have caffeine 4-6 hours before bed. 

Avoid alcohol. Don't drink 4-6 hours before bed. 

Bed is for sleeping. Try to only use your bed for sleeping - no reading, tv, etc. 

No naps. Try not to take naps, but f you need one, nap before 3pm for less than 1 hour. 

Sleep rituals. Try deep breathing or relaxing stretching for 15 minutes before bed.

Bath time. Having a warm bath or shower 1-2 hours before bed can make you sleepy. 

No clock-watching. Try not to look at the clock if you're having trouble staying asleep.

Use a sleep diary. For two weeks track your sleep, so you better understand what helps.

Exercise. Try regular exercise, especially in the morning or afternoon


Eat right. A balanced diet helps. Try not to eat too much right before bed. 

The right space. Try earplugs, eye mask, and a cooler room with blankets. 

Keep daytime routine the same. Try not to avoid activities in the day even if you feel tired.

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