woman sleeping in bed

6 Strategies for Better Sleep Despite Chronic Pain

By Lauren Krouse
March 11, 2024

When you’re living with chronic pain, nights are often the worst. As you settle into bed and the usual daytime distractions fade away, the discomfort can become all-consuming. One in five Americans suffers from chronic pain, and most say they’re missing out on quality shut-eye because of it, per a recent Sleep in America survey by the National Sleep Foundation.

Jude Avril Duncan, a 28-year-old digital marketer, says she often struggles to fall and stay asleep when flare-ups from psoriasis or psoriatic arthritis arise, bringing with them heat, itchiness, aches and pains, or all of the above. “When you put them together, it’s even worse,” she says. “I can go from having eight hours of sleep per night to around three to four.”

Work-related pain is also a common trigger for sleepless nights. Tommy Fox, 29, a Richmond-based visual artist, says his hand pain tends to become worse after a long day in the studio, sanding and drilling wood or stapling canvas. “It can keep me up worrying,” he says. “My hands are my tools, and when they ache or feel numb, I question my ability to do the thing I love.”

Whether you’re struggling to manage symptoms of a chronic condition like arthritis or fibromyalgia, dealing with an ongoing injury, or battling spin-off pain after major surgery or cancer, the combination of pain, distress, and disrupted sleep can create a vicious cycle. Without rest, pain can become increasingly intense and frequent—making fitful sleep even harder to come by. On top of this, nearly half of chronic-pain patients could also be living with a sleep disorder, such as insomnia or sleep apnea, according to research.

The good news is: You can break the cycle. Here, people share how they’ve learned to manage their chronic pain for a better night’s sleep.

1. Get a Diagnosis and Treatment Plan

“Finding out what is causing the pain is the first step to a viable solution,” says Simon C., 31, whose chronic pain arose after hip surgery six years ago. If you haven’t already, reach out to a healthcare provider to determine what’s triggering your pain or why it may be getting worse. Depression, anxiety, sleep disorders, and autoimmune disorders, among many other health conditions, often co-occur with chronic pain. When left untreated, they can exacerbate nighttime pain and fragmented sleep.

For Simon, searching for a comfortable sleeping position at night not only caused pain but was also frustrating and anxiety-inducing (not what you want when you’re trying to ease into sleep!). In order to get relief, he asked a friend who worked in the medical field to recommend hip specialists and scheduled an exam.

“I’ve learned that my pain is caused by a hip impingement which I am now fixing with a second surgery and physical therapy,” he says. His recommendation: Practice self-advocacy, ask people you trust for referrals to reliable physicians, and look into a few doctors before making a final decision.

2. Make Time for Movement During the Day

Jess Kszos, a 30-year-old photography student living with scoliosis and ankylosing spondylitis, a type of arthritis that causes pain and stiffness in the spine, says the advice she gets to relieve pain is often along the lines of “Take breaks.” But she says staying active has actually been more beneficial for her than being stationary.

“My body basically stiffens up if I don’t move around,” she says. Her surprise fix? Getting a job at Target. “I’m able to walk at least 10,000 steps each time I work, and bending, lifting, and moving around help me to be in less pain,” she says. Kszos believes moving frequently throughout the day and making time for stretches her physical therapist taught her seem to contribute to better sleep—and research backs this up.

For people living with inflammatory conditions like arthritis, regular physical activity is one of the simplest, most accessible ways to cut down on inflammation and disrupted sleep. Case in point: Just 20 minutes of exercise could lower inflammatory markers in your blood that are associated with pain and poor sleep, found a study published in the journal Brain, Behavior, and Immunity.

3. Create a Nightly Wind-Down Routine

No matter where you fall on the pain scale, it helps to make sure you’re setting the right foundation for quality shut-eye—especially if you’ve been delaying your bedtime due to discomfort or waking up periodically throughout the night. Start with an evening routine that helps you get into the right mindset for sleep.

Randi Blackmon, a 24-year-old student living with rheumatoid arthritis, swears by basic sleep-hygiene measures, like sticking to the same bedtime and wake time each day to help her manage fatigue and get the sleep she needs. A regular schedule helps regulate circadian rhythms (also known as your body clock), according to Harvard Health. Purchasing a pair of blackout curtains for your bedroom or blue light-blocking glasses to wear a few hours before bed could also help by promoting your production of melatonin, the hormone that tells your body it’s time to ease into sleep mode.

Beyond helping you shift into a sleepier state, a nightly routine could serve as a designated time to manage symptoms and give you some welcome distractions from pain. When Blackmon takes a shower at night, she envisions herself “washing off the tough parts of the day and letting them run down the drain” to ease stress.

Similarly, Duncan unwinds with a full skincare regimen, applying gentle and hydrating cleansers, toner, and moisturizer to her face and moisturizer on her body, applying ointment to any patches of psoriasis. She follows that up with by some light reading and an episode or two of her favorite show, The Simpsons. “It helps distract my mind and is something I don’t need to focus on too heavily, since I’ve seen the episodes multiple times,” she says. “This allows my brain to switch off and therefore not think of the flares.”

4. Dull the Pain with Cold Therapy

Another tried-and-true pain reliever is cold therapy, aka cryotherapy. From frozen gel packs to ice baths, cooling off sore areas can temporarily lower bloodflow and nerve activity and, in turn, dial down swelling and pain, according to Johns Hopkins Medicine.

“Coldness really helps me,” says Duncan. She regularly runs cool water over a face cloth to apply to itchy patches of psoriasis and keeps moisturizer in her fridge for middle-of-the-night flare-ups. She swears by Aveeno Daily Moisturizing Lotion and Kiehl's Ultra Facial Cream, which she says are “super-hydrating” and “help calm angry skin.” She also keeps her room cold by sleeping with her window open—another measure that helps keep her symptoms to a minimum at night.

For sore hands, Fox uses a cold therapy wrap, which, unlike old-fashioned ice packs, stays malleable even when it’s cold for greater efficiency and comfort. “I try to use it almost every morning and every night for a little while regardless of my pain level rather than going overboard when I’m already hurting,” he says.

A few pro tips: Make sure to wrap an ice pack with a thin towel to avoid damaging your skin with extreme cold. Apply the cold pack to your skin and take it off in 10- to 20-minute increments, and skip this one (or consult with your doctor for other options) if you have a condition such as diabetes that could reduce sensation in certain areas.

5. Try Practicing Mindfulness

Stress is a common trigger for chronic pain and flare-ups alike. But some studies suggest that mindfulness meditation—or rooting yourself in the present moment and watching your thoughts, feelings, and sensations without judgment—could help reduce chronic lower-back aches, as well as pain from headache, fibromyalgia, and irritable bowel syndrome (IBS). It could even lower your sensitivity to pain.

Blackmon says symptoms of arthritis can cause her excruciating pain, and long periods of stress usually mean “a big flare is coming.” So, she tries very hard to keep her stress levels low. Her solution: A Hatch Restore sound machine, which guides her through 10 minutes of meditation followed by soothing sounds to help her drift into sleep. “The meditation helps calm my mind and lower my stress levels,” she says.

If you’re not into meditation, other practices like mindful movement, body scans, and deep breathing exercises come with the same benefits and may be worth a try.

6. Lean on a Support Group

By definition, chronic pain is complex, long-lasting, and often difficult to manage. That’s where connecting with people who truly understand the type of pain you’re dealing with can be indispensable.

Kszos says online groups related to her conditions have been extremely helpful to her. When new issues pop up—like shoulder pain—she can post in one of her support groups to find out more about others’ experiences with that issue and what’s been helpful to them for finding relief.

Getting tips from others can give you ideas on how to better manage your pain and support better sleep. A bonus: Giving back with your own hard-earned insights can also be a real mood booster. You can find support groups online, ask your healthcare provider for a referral, and connect with others right here in our community.

You May Also Like: