Does The Quality of Your Sleep Affect Your Pain?

Written By Michael Griggs, PT, DPT, OCS

Having musculoskeletal pain can be stressful, but it can be even more stressful to be unable to get restful, restorative sleep due to your pain. A recent article published this month in the journal Pain details the complex relationship between sleep and pain. The authors note the frustrating vicious cycle of sleep and pain: “the relationship between sleep and pain is bidirectional since insufficient sleep can precede and maintain pain while pain can impair one’s ability to initiate and maintain sleep.” Improving your sleep can have a very significant effect on your pain and vice versa, managing your pain can improve sleep. Here are a few quick ideas to ensure you are getting optimal, restorative sleep.

3 tips to improve the quality of your sleep:

1. Determine how much sleep you really need:

  • The National Sleep Foundation recommends 7-9 hours of sleep for adults aged 26-64 and 7- 8 hours of sleep for adults over 65.

2. Practice good “sleep hygiene.” offers some great tips on improving the quality of your sleep. Here is a summary of good sleep hygiene practices:

  • Limit daytime naps to 30 mins.
  • Avoid stimulants (caffeine/nicotine) close to bedtime (or even after 3-4pm). Avoid alcohol – while it does make you drowsy and may help you fall asleep, it negatively affects the quality of your sleep.
  • Exercise regularly (even 10 minutes of aerobic exercise and improve sleep quality).
  • Maintain a cool sleeping environment.
  • Limit your bed and bedroom for sleep and sex only
  • If you aren’t sleepy, don’t stay in bed and toss and turn, leave the bed and bedroom, go sit on the couch, and read a book or magazine. When you feel sleepy, return to your bed/bedroom.
  • Limit use of your phone/electronics before bed, if possible try to keep them in another room.
  • Stick to a sleep schedule, even on weekends. Go to bed and wake up at the same time.

3. Find the perfect sleeping position. If you are experiencing pain, it can be very difficult to find a comfortable sleeping position.

Your physical therapist can discuss sleeping positions for your specific condition/situation, but this infographic from the Wall Street Journal has some very good starting suggestions.

Some general tips:

Shoulder pain – sleep with the painful side up and well supported on a thick pillow. Use a thick pillow under your head/neck to keep your cervical spine neutral.

Jaw Pain or Headaches – sleep on your back with a thick pillow under your head and not your neck. Avoid sleeping on your stomach.

Hip Pain – sleep on your side with the painful side up and a thick pillow between your lower thighs and knees.

Low Back Pain – sleep on your back with a pillow under your knees or on your side with a pillow between your knees with the top knee bent and the bottom leg straight. Avoid sleeping on your stomach.

Finally, try to avoid negative self-talk that your sleep will “never” improve! Like all things that are worth the effort, it can take time to improve your sleep quality and number of hours you sleep each night. If you feel frustrated, speak with your physical therapist about additional ideas to manage your pain and improve your sleep. Your physical therapist may even want you to fill out a sleep quality assessment form to better assess your sleep quality and track your progress.

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