What Is Painsomnia?

• Depression
• Obesity
• Type 2 Diabetes
• Dementia
• Heart disease

Painsomnia is a term sometimes used to describe how chronic pain can prevent good quality sleep. You may have it if pain keeps you up at night, or wakes you during sleep.

But how exactly does sleep quality affect pain? The answer lies in several biological processes that can be affected by poor sleep and lead to worsening of pain symptoms.

Poor sleep can also affect your overall health and well-being. Thomas Nguyen, MD, an interventional pain specialist at VSI, formerly Virginia Spine Institute in Reston, Virginia, says, “If we cannot achieve good, healthy, and restorative sleep, every aspect of your health can be affected: your immune system, mental health, energy levels, weight, focus and even longevity. It can also lead to poor concentration, memory issues, and increased inflammation — which plays a key role in chronic pain.”

• Aching
• Burning
• Shooting
• Squeezing
• Stiffness
• Stinging
• Throbbing

• Difficulty falling asleep
• Waking through the night
• Waking too early
• Feeling tired, cranky, depressed, or anxious during the day
• Difficulty concentrating
• Making more mistakes or having accidents
• Worrying about sleep

Painsomnia can be related to various chronic conditions. Dr. Dimitriu says, “Fibromyalgia, arthritis, migraine, and neuropathy are among many conditions in which pain can impair sleep. Most notably, certain pain conditions may not even result in insomnia but can still impact sleep architecture — most often preventing the body from entering deep restorative sleep (stage 3, slow-wave sleep). Unfortunately, a lot of healing and rejuvenation occurs in stage 3 sleep, so when it's interrupted, it can create a vicious cycle.”

Speaking with your doctor should be the first stage in treating painsomnia. Chris Scuderi, DO, a family physician at Millennium Physician Group in Jacksonville, Florida, says “Your family physician is an essential first step in assessing your symptoms and determining whether specialist care is required. In some cases, your physician may refer you to a sleep specialist, pain management expert, or even recommend cognitive behavioral therapy to address insomnia and pain holistically.”

• Pain medication
• Medication to help you sleep
• Maintaining a regular sleep cycle
• Keeping a sleep diary
• Getting daily physical activity
• Avoiding tech for at least an hour before bed
• Limiting caffeine and alcohol
• Limiting use of your bed to sleeping and sex
• Taking part in relaxation techniques, such as yoga or meditation
• Undertaking cognitive behavioral therapy (CBT)
• Going for a sleep study

Unfortunately, there may be some cases where painsomnia is unavoidable. However, Dr. Nguyen says, “There are steps you can take to reduce your risk of developing painsomnia. Prevention comes down to consistently addressing both pain and sleep by taking care of your body during the day and setting yourself up for quality rest at night.”

The most important part of prevention is breaking the “painsomnia cycle.” In order to help reduce poor sleep, you must manage pain, and vice versa. Nguyen says that this may involve speaking with a pain specialist, maintaining a healthy weight, and staying active. He also notes that stress management and good sleep hygiene can help you develop good sleeping patterns.

Painsomnia develops in people with conditions that cause chronic pain, such as:

• Fibromyalgia Fibromyalgia can cause you to have trouble falling or staying asleep, or leave you feeling tired even after sleeping through the night. Poor sleep can then lead to increased pain.

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• Chronic Back Pain People with chronic back pain frequently report sleep disruptions. The more intense the pain, the more sleep disturbances you have.

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• Arthritis Around 80 percent of people with arthritis have trouble sleeping. Many people with arthritis say they feel more pain after a poor night’s sleep.

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• Neuropathy Neuropathic pain can be worse at nighttime. This may be because there are no daily distractions to take focus off the pain. It may also be due to changes in temperature, stress, or needing to adjust medication timings.

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• It’s important that you break the painsomnia cycle in order to reduce pain levels and get better sleep.
• Although painsomnia can be a frustrating condition, there are many options available to help you manage it, such as painkillers and CBT.
• Making lifestyle changes and maintaining good sleep hygiene can be great steps to help you reduce painsomnia symptoms.
• If you have any signs of painsomnia, speaking to a doctor can help you build a personalized treatment plan.