What Is Painsomnia? Symptoms, Causes, And Treatment

Sleep plays an integral role in your health and quality of life. Chronic sleep deprivation can cause serious health problems, including heart attacks, diabetes, and strokes. 

Painsomnia describes the lack of sleep due to pain. While it's not a medical term, people use it when their pain interferes with their sleep. Officially, it falls into the category of "insomnia due to a medical condition."

Understanding painsomnia can help you identify the condition and seek appropriate treatment. Let’s learn more. 

What is painsomnia?

Painsomnia is insomnia due to pain. People with chronic pain are at a higher risk of experiencing sleep problems. Around 20% of people with chronic pain report insomnia symptoms in the general community, compared to 7.4% without pain.¹

Nine out of ten who seek treatment for their chronic pain conditions list sleep issues as a coexisting problem, and 65% identify as "poor sleepers."

Sleep allows your body to get sufficient rest and heal. That's why good-quality sleep is crucial if you have chronic pain. Research shows that one of the key predictors of pain intensity is how much sleep you get the night before.²

Painsomnia doesn't allow people with chronic pain-related conditions to get the relief they need.

Can insomnia cause chronic pain?

While pain can cause insomnia, lack of sleep can be a risk factor for developing chronic pain.  A 2016 longitudinal study demonstrated that insomnia and short sleep duration could cause a person to develop chronic pain in their joints, muscles, bones, ligaments, and tendons.

Scientists report that untreated insomnia could aggravate pain perception. People with insomnia symptoms are at least three times more likely to have a chronic pain condition.³

This two-way relationship between pain and insomnia can lead to a vicious cycle that significantly affects your quality of life. If you have insomnia symptoms, speak to your doctor.

Symptoms of painsomnia 

The main symptom of painsomnia is the inability to fall asleep due to pain and discomfort. When you experience pain, your nerves are stimulated. This stimulates your brain and keeps you awake. Additionally, your muscles can't relax enough for you to fall asleep.

With time, pain could disrupt your circadian rhythm (sleep-wake cycle) and contribute to chronic sleep problems. This could also make you feel tired during the day and interfere with your ability to fall asleep at night.

Depending on the underlying condition, pain contributing to insomnia can include aches, burning, and tingling. The levels of discomfort can vary.

If your painsomnia is due to chronic health conditions, such as arthritis, diabetes, or cancer, you may experience symptoms such as loss of appetite, digestive issues, and mood changes.

During the day, you may experience a lack of concentration, fatigue, low energy, and excessive worry about upcoming sleep issues.

Causes of painsomnia 

The leading cause of painsomnia is pain. Aches, tingling, burning, and other pain variants can disrupt your sleep in different ways.

Disruption of sleep cycles

To get sufficient sleep, you need to go through dozing, light sleep, deep sleep, and REM (rapid eye movement). If pain wakes you up during the night, it disturbs your cycle. This interferes with sleep quality or your ability to fall back asleep.

Issues with sleeping position

If you live with arthritis, pain may affect the way you sleep. You could have trouble falling and staying asleep if you can't feel comfortable in your favorite sleeping position.

Pain medication

Some medication that you may be taking for pain relief could cause insomnia. These meds include high doses of NSAIDs, Excedrin (because it contains caffeine), and prescription opioids.

Pain that causes insomnia is a symptom of underlying conditions, including: 

• Fibromyalgia (musculoskeletal pain)

• Bruxism (grinding teeth in your sleep)

• Rheumatoid arthritis (70% of people with rheumatoid arthritis suffer from sleep disorders)

• Nerve damage

• Chronic pain syndrome

• Severe cases of shingles

• Osteoarthritis

• Endometriosis (when the tissue lining the uterus starts growing outside of it)

If you have painsomnia, your doctor will try to identify the underlying condition. Treating these conditions can alleviate the pain and contribute to better sleep quality.

How to treat painsomnia 

While you are addressing the underlying health issues, your doctor may suggest several techniques to improve your sleep quality.

Sleep hygiene 

Sleep hygiene is a set of habits that contribute to getting a good night's sleep. They include:

• Going to bed and waking up at the same time every day

• Ensuring the comfort of your bedroom:

  • No light

  • Comfortable temperature

  • Comfortable bedding

  • No distractions

  • No clock

• Avoiding electronic devices for at least 30 minutes before going to bed

• Avoiding large meals, coffee, nicotine, and alcohol before bed

• Exercising during the day

• Only using your bed for sleep and sex

• Leaving your bed if you can’t fall asleep within 20 minutes

It's essential to follow these tactics consistently regardless of the day of the week, season, or work schedule.

Cognitive behavioral therapy for insomnia (CBT-I)

CBT-I is the first-line treatment for people with insomnia. Besides pain, your thoughts, feelings, and behaviors could contribute to your sleep problems. This therapy focuses on creating the right connection between how you think and sleep.

The most effective part of CBT-I that helps people with painsomnia is behavioral interventions, including relaxation training. You can learn how to relax your body, meditate, and deal with pain.

Studies show that mindfulness meditation (when you focus your thoughts and feelings inward) can ease pain. Once the pain subsides, you can get a good night's sleep.⁴

Pain meds

Speak to your doctor about pain medication that can alleviate your symptoms and help you sleep at night.

The type of medication your doctor recommends depends on your underlying conditions and medical history.

Your doctor may also suggest alternative pain alleviation methods, such as meditation, relaxation techniques, and physiotherapy. 

The lowdown 

Painsomnia is insomnia caused by pain. If you have a medical condition that causes pain, you could face a lack of sleep at night. Treating painsomnia starts by identifying the underlying condition and addressing it. CBT-I, pain medication, and sleep hygiene can also help.

If you think you have painsomnia, contact your doctor. They can create an effective course of treatment and improve your sleep quality.

Frequently asked questions

Which came first: Chronic pain or lack of sleep?

The connection between chronic pain and lack of sleep works both ways. Chronic pain can cause insomnia. Meanwhile, problems with continuous sleep or lack of sleep could cause chronic pain.

Who is at risk for painsomnia?

If you have a health condition that causes pain, you could develop painsomnia. You may experience painsomnia if you have rheumatoid arthritis, fibromyalgia, endometriosis, osteoarthritis, shingles, nerve damage, cancer, and many more conditions.

Why does my pain get worse at night?

Cortisol is a potent anti-inflammatory hormone that plays a critical role in our sleep-wake cycle. However, cortisol production drops to its lowest point around midnight and doesn’t rise until 2–3 hours after sleep onset. This dip in cortisol levels could mean a rise in discomfort, making it difficult to fall asleep or stay asleep. 

It’s also possible that sleeping in the same position could worsen the pain. 

Doctors believe you’re distracted by different stimuli during the day, so you don't pay as much attention to the pain as you do at night.