Painsomnia: Insomnia Caused by Pain

For people living with various chronic conditions like arthritis or ankylosing spondylitis, lack of sleep may be yet another obstacle to their health. Many people struggle to fall or stay asleep because of their pain.

This condition is called painsomnia—insomnia caused by pain. Painsomnia is not considered a true medical term, but it is recognized as a real condition. 

Sleep helps our bodies rest and heal, so good-quality sleep is vital for people with chronic illnesses. However, painsomnia can make a good night of sleep feel like a pipe dream. Fortunately, medical researchers are starting to learn more about the condition and how patients can cope. 

Painsomnia Symptoms

Why does pain prevent you from falling and staying asleep? During sleep, your muscles and joints relax. However, if you are in pain, your body may not relax enough to fall asleep.

If you feel pain, you may toss and turn in the night to try to find a more comfortable position—this tossing and turning can prevent you from getting deep, restful sleep. Additionally, it’s easier to fall asleep if you psychologically feel safe and secure, and pain can keep you on edge.

If pain continues to interrupt your sleep, it may disrupt your circadian rhythm, which is the natural clock that helps your body know when to wake up and when to fall asleep. A disrupted circadian rhythm may make you feel tired in the middle of the day or wide-awake at night.

Common pain symptoms that contribute to painsomnia can include burning, tingling, or aching sensations. Depending on what causes your pain, you may feel different sensations. For example, nerve pain may feel like needle pinpricks while rheumatoid arthritis pain may feel like a deep twisting in your joints.

The pain may come and go. Some people report feeling waves of pain throughout the night. Just when they’ve managed to fall asleep, they may awake with discomfort.

Other people, especially those with joint problems like arthritis, may feel worse pain throughout the night into the morning. The longer they lay down, the stiffer their backs, knees, or legs may feel when they wake up. Whatever pain you are experiencing, it’s important to recognize when you need to consult a healthcare professional.

Who Is at Risk?

Any kind of pain can prevent restful sleep. People with chronic pain, or pain that lingers for weeks at a time, are at higher risk for developing long-term sleep problems.

Some of the most common types of pains that keep people up at night are headaches and back pains. The National Sleep Foundation also lists cancer pain and post-surgery pain as barriers to sleep.

People with fibromyalgia are also at risk for painsomnia. A study reported that women with fibromyalgia can wake up twice as often throughout the night as do people without the condition.

Various psychiatric conditions are closely connected with painsomnia, such as depression. People with depression report feeling bodily aches and pains, fatigue, and disrupted sleep. Additionally, some people may find that their painsomnia makes their existing depression even worse. Good sleep promotes psychiatric health, so painsomnia can exacerbate mental illness symptoms. 

Other conditions that may cause painsomnia include but are not limited to: 

• Tooth or jaw issues like abscesses or grinding your teeth 
• Arthritis, including rheumatoid arthritis 
• Endometriosis 
• Multiple sclerosis 
• Shingles 
• Neuropathy, or nerve damage 
• Chronic pain syndrome

Because pain is subjective, many people will experience these conditions with different symptoms. Some people with arthritis, for example, will struggle to sleep. Others may not. Additionally, chronic conditions can change over time. If you notice your pain becoming more severe, or if you begin to feel new pains that keep you awake, please consult your healthcare provider.

Treatment

Because painsomnia is not an official disorder, there are currently no definite cures or treatments. However, patients can use a variety of techniques to both help manage their pain and promote better sleep. 

Better Sleep Habits

The MD Anderson Sleep Center recommends that people adopt new habits into their nightly routine. These habits help form the foundation for good sleep hygiene:

• Don’t use phones or computers before bed, as the blue light from the screen can disrupt sleep and cause eye strain.
• Avoid taking long naps during the day.
• Make your bedroom cool and dark.
• Avoid eating heavy foods or exercising right before you sleep.

Sleep Aids

If you have trouble sleeping, your healthcare provider may prescribe sleep aids or encourage you to try over-the-counter medications. These drugs can help regulate your circadian rhythm and lull you into slumber. Melatonin supplements help regulate your sleep cycle.

A study from Cureus journal found that ashwagandha, a medicinal herb, can help people fall and stay asleep.

Prescription drugs may include benzodiazepines, which are often used to treat anxiety and insomnia. Before you try any new supplements or prescriptions, make sure to consult your healthcare provider. 

Cognitive Behavioral Therapy

Cognitive behavioral therapy is a treatment that encourages people to rethink and change their behaviors. For people with insomnia, cognitive behavioral therapy may help,

For example, a person without a sleep routine can work with a therapist to start better habits before bed. If anxious thoughts are keeping you up at night, cognitive behavioral techniques can teach you to stop those spiraling thoughts and focus on other, more restful thoughts.

If your painsomnia makes you feel helpless, those worries can make it even harder for you to get sleep. You may blame yourself or blame your body if you’re struggling with painsomnia. Cognitive behavioral therapy can help you cope with some of that frustration. 

Hypnotherapy

While hypnotherapy is not a proven cure for painsomnia, some researchers have found that hypnosis might improve insomnia. Hypnotherapy is an alternative medicine where practitioners use hypnosis and the power of suggestion to guide patients through various concerns.

Hypnotherapy is not a replacement for your healthcare provider or your current medications. Some researchers describe hypnotherapy as a sort of placebo. In either case, hypnosis can lull you into deep relaxation. This relaxation may help people with painsomnia fall asleep. 

Coping

People with painsomnia may feel like they are fighting their bodies and fighting preconceived notions. A common misconception about painsomnia is that it’s “all in your head” or that painsomnia is a psychosomatic condition.

If you tell loved ones about your painsomnia, some people may reply that you are just stressed. Whether your pain is psychological, physical, or both, it’s important to know that you deserve relief. Painsomnia is a very real experience for many people, and your healthcare provider can help you navigate your symptoms. 

A Word From Verywell

Much remains unknown about painsomnia as an actual medical condition. Nontheless, pain can be emotionally and physically exhausting. In some cases, you may be stuck in a cycle where your pain causes your insomnia.

Without the rest you need, you may feel more pain when you wake up each morning—which contributes to this painsomnia cycle. Fortunately, self-care can help you manage the problem.

You can give yourself the best chance for a good night’s sleep when you maintain a regular routine, get exercise, follow your existing medical plan, and avoid using your computer or phone before you go to bed. Meditation techniques like progressive muscle relaxation can help mitigate minor to moderate nighttime pains.