Sleep And Chronic Pain

Millions of people around the world suffer from chronic pain that adversely affects many aspects of their lives, including sleep.
Sleep and chronic pain

Chronic pain affects about 25% of the Spanish population. In a study of 5,000 participants, 43 percent reported experiencing pain in the previous week, particularly in the legs, back, or head. About 54 percent of them said they suffered from long-term, chronic pain that had a significant negative impact on their lives. In today’s article, we look at how sleep and chronic pain are related.

The most common causes of chronic pain are arthritis, rheumatism and migraine. More than 60% of patients said they used painkillers to relieve pain. These medications can have a variety of side effects with long-term use, including ailments that can make the pain worse.

Sleep and chronic pain are related

Effects of chronic pain

If you suffer from chronic pain, you know how detrimental it can affect a person’s life. Persistent physical pain also causes significant mental distress. In most cases, the following areas of life are most affected by chronic pain:

  • Sleep
  • Social life
  • Cognitive abilities
  • Physical activity
  • Performance at work
  • Various daily chores (taking a shower, shopping, cooking, driving a car, writing, etc.)

Chronic pain also increases the risk of mental disorders such as anxiety and depression. Unfortunately, such prolonged pain can also lead to chronic stress.

Sleep and chronic pain

The quality of a patient’s sleep is considered an essential variable in determining whether or not a treatment plan for chronic pain is working. About 50 to 70 percent of patients with moderate to severe chronic pain also have some form of sleep disorder. This is especially true for older people. The most common sleep disorders are:

  • Difficulty falling asleep
  • Waking up in the middle of the night due to pain
  • Restless sleep
  • Fatigue during the day

Due to the pain, it is very difficult for these patients to get a good night’s sleep. This in turn causes hyperalgesia, or sensitized pain. Sensitization to pain again makes it difficult to sleep, creating a vicious circle that is difficult to break.

Sleep and chronic pain: how painkillers affect sleep

Although medications prescribed for chronic pain can relieve symptoms, they also affect the quality of sleep. Here are some of the most commonly used medications.


These are among the most widely used painkillers among adults. They not only reduce inflammation but also reduce fever, swelling and redness. They are prescribed for chronic health problems such as arthritis or rubella.

Unfortunately, NSAIDs also impair sleep and increase nocturnal awakening. Here are the three most common reasons for this:

  • Decreased production of prostaglandins.
  • They interfere with the release of melatonin.
  • Abdominal irritation due to prolonged use.


Opioids are only safe for a short time under close medical supervision. Their long-term use is addictive. If opioids are not used properly, overdose or even death can result. This is why they are prescribed by doctors very carefully.

Opioids reduce REM sleep and slow-wave sleep, both of which are required for proper physiological course of sleep.


Corticoids are mainly prescribed to reduce inflammation in diseases such as arthritis, asthma, rubella, multiple sclerosis and some types of cancer.

Their long-term use can, among other things, weaken bones or cause cataracts. Therefore, they are usually prescribed only in short courses.

How do they affect sleep? High doses work just like opioids: they reduce REM sleep and slow-wave sleep.

Summary: sleep and chronic pain

The scientific literature refers to the direct link between chronic pain and sleep disorders. Pain makes it difficult to get restful sleep, and lack of sleep increases pain sensitivity.

It is important to keep in mind that sleep is affected by numerous factors. Age plays an important role, as do the drugs used. However, it is important not to rule out other comorbidities or external conditions that prevent you from getting a good night’s sleep and increase sensitivity to pain.

If you are taking painkillers for chronic pain, you may want to switch to fast-release medications for slower-release medications. Indeed, studies show that the latter can reduce the incidence of analgesic-related sleep disorders.

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