Sleeping Poorly? It Could Be Making Your Chronic Pain Worse
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This Everyday Factor Could Be Making Chronic Pain Harder To Manage
Author:
October 24, 2026
mindbodygreen editor
Image by Studio Firma / Stocksy
October 24, 2026
When chronic pain keeps you up at night, getting enough rest can feel an uphill battle.
You might focus on finding a comfortable sleeping position or easing the ache enough to drift off, but there’s more to the picture than getting through the night.
A review of 57 studies1 explores how sleep, inflammation, and musculoskeletal pain interact, including the biological processes that may keep symptoms going. It also examines which non-drug treatments could help address these overlapping challenges.
About the review
Published in Pain Management, the review examined research from 2010 to 2025, including experimental and observational studies, systematic reviews, meta-analyses, and narrative reviews.
This allowed researchers to consider both findings from individual studies and broader patterns across the existing evidence.
They explored how sleep disruption may affect inflammation and pain sensitivity, how pain can interfere with sleep, and which non-drug approaches might help interrupt this cycle.
They also considered the strength of the available evidence, distinguishing treatments supported by clinical research from those that still need further testing.
Which treatments could help break the cycle?
The review identified aerobic exercise and cognitive behavioral therapy for insomnia (CBT-I) as approaches with stronger supporting evidence.
- Aerobic exercise: Activities such as walking, swimming, or cycling may help people manage musculoskeletal pain while supporting overall health. The right intensity depends on individual symptoms and abilities.
- CBT-I: This structured therapy addresses the thoughts and habits that contribute to insomnia. It is an established treatment for persistent sleep difficulties and may be especially helpful when pain and sleeplessness overlap.
Other approaches, including hands-on manual therapy, neuromuscular electrical stimulation, and low-level laser therapy, showed potential.
However, the evidence supporting these treatments is more preliminary, and larger, well-designed clinical trials are needed to establish how effective they are.
RELATED READ:This Is The Best Magnesium To Wind Down Before Bed
How poor sleep may turn up the body’s pain response
Sleep and pain can feed into each other. Pain may make it harder to fall asleep or stay asleep, while disrupted sleep may leave you more sensitive to pain the next day. Over time, this back-and-forth can become a difficult cycle to break.
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Inflammation may help explain why. When sleep is restricted, levels of certain inflammatory markers, including interleukin-6, tumor necrosis factor-alpha, and C-reactive protein, may rise.
Some inflammatory compounds can make nerves more sensitive to pain signals, potentially amplifying discomfort.
Sleep disruption may also interfere with the body’s natural pain-control systems.
The brain helps dampen incoming pain signals, while the body produces its own opioid-chemicals that help regulate pain. Poor sleep may weaken these systems, making discomfort feel more intense while reducing the body’s ability to manage it.
The size of these effects varies by person and type of sleep disruption. Still, these mechanisms help explain why a bad night can make an already painful day feel even harder.
Why sleep belongs in the pain conversation
Pain assessments often focus on where it hurts, how intense the discomfort is, and how much it affects everyday activities.
The review suggests that sleep deserves a place in that conversation, too.
Healthcare professionals can use questionnaires such as the Pittsburgh Sleep Quality Index and the Insomnia Severity Index to assess sleep quality and insomnia symptoms. These tools can help identify sleep problems that may need attention alongside pain itself.
The authors also call for more high-quality research. Future trials should measure sleep, inflammation, and pain together to clarify how these factors interact and which treatments make the biggest difference.
What you can do now
If pain and poor sleep are affecting your daily life, a few practical steps may help you start addressing both.
- Talk about sleep at your next appointment: Tell your healthcare professional if pain wakes you up, makes it difficult to fall asleep, or leaves you feeling unrested. Ask whether insomnia treatment, including CBT-I, could be appropriate.
- Find movement that works for you: If your symptoms allow, try a manageable form of aerobic exercise, such as a short walk or gentle swim. A physical therapist or healthcare professional can help you adapt activity to your needs.
- Keep your sleep routine consistent: Aim for regular bedtimes and wake times, and give yourself time to wind down before bed. These habits aren’t a cure for chronic pain, but they can support healthier sleep.
The takeaway
Pain may be the reason you’re awake, but it isn’t necessarily the whole story.
Giving sleep the same attention as your symptoms, with support from a healthcare professional, could help you find a more complete approach to feeling better.
magnesium+ rest & recovery
★ ★ ★ ★ ★
★ ★ ★ ★ ★
(127)
★ ★ ★ ★ ★
★ ★ ★ ★ ★
(127)
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