Combining the words ‘pain’ and ‘insomnia’ (a disorder where people struggle to fall and stay asleep), it sums up the vicious circle we can feel at night when pain keeps us awake.
- The sensation of pain (aching, burning, tingling) stimulates the nerves
- This activates the brain
- As a result, people can’t relax and are kept awake by the pain and anxiety
Because sleep helps the body heal, “painsomnia” can make chronic illnesses worse and hinder recovery from certain experiences, such as a painful operation.
Depending on the possible causes, sufferers may:
- Feel a pain that comes and goes
- Feel waves of pain throughout the night
- Suffer all night with pain and sleeplessness
“Painsomnia”: Why Body Aches And Pain Can Be Worse At Night
Body aches and pain are bad enough during the day. But even when your body only aches at night, this can rob you of much-needed rest – and sometimes become a bit of a nightmare.
“Painsomnia” may prevent you from getting to sleep – or give you a rude awakening if you do. Given just how important sleep is for us, understanding the causes of your discomfort and reducing it can be hugely helpful.
If you think you suffer from “painsomnia”, you’re not alone. According to the National Sleep Foundation, one-in-five Americans suffer chronic pain, and one in four of those also have a sleep disorder2.
In this article we’ll explain why pain is sometimes worse at night, and the different types of night-time pain you might experience. The good news is, we’ll also provide useful tips for helping you get a better night’s sleep. As always, talk to your doctor if you have questions or concerns about your sleep.
Why Pain Can Be Worse At Night
There are many reasons why you might feel muscle cramps or body aches at night only. Common causes of pain at night include:
- Hormone levels – production of the anti-inflammatory hormone cortisol drops to its lowest point at around midnight, so this could see discomfort rise for certain ailments3
- Sleep position – staying in one position all night can cause your joints to get stiff. Sleeping on your stomach, meanwhile, may put strain on your back4
- Body temperature – inflammatory musculoskeletal pain can respond well to heat5, but experts also recommend keeping your bedroom cool at night to aid sleep6. As a result, balance is important!
- Multiple sclerosis – symptoms including fatigue, tingling and stiff muscles can be common for people with this condition7
- Arthritis – this can be a common reason for swelling and joint pain at night, particularly when it comes to rheumatoid arthritis8
Types Of Body Aches At Night And Symptoms
Many different kinds of aches and pains can lead to “painsomnia”:
Also known as neuropathy, nerve pain can be felt at night as a burning sensation, tingling, or ‘pins and needles’9. It may be caused by injury to a single nerve, e.g. carpal tunnel syndrome, or a group of defective nerves.
Body temperature changes are also a possible cause of nerve pain, because experts believe that when the temperature drops at night, damaged nerves may interpret the change as pain or tingling9.
Muscle pain at night can feel like a steady deep ache, or random sharp pain. The pain can be all over or in specific areas.
Muscle cramps can be a result of injuries, including back problems such as herniated disks, or conditions like spinal stenosis and scoliosis (curvature of the spine)10. Fibromyalgia, a lifelong condition, can cause stiff muscles at night too11.
Bone pain at night is often described as a penetrating, deep pain, made worse when the bone is moved.
Our bones can ache at night for a wide variety of reasons. If you’ve suffered a break or fracture, or have an infection, this can lead to discomfort.
Hormone deficiencies such as those due to menopause may also lead to bone pain, or even osteoporosis12.
Bone cancer is also a potential cause13 - but rest assured there are many possible explanations. If you are concerned, be sure to seek advice from a medical professional.
Joint pain experienced at night can be brought on by chronic conditions such as arthritis, leading to sore legs, hips and shoulders14. There are many types of arthritis, from common kinds like rheumatoid, to less common types such as ankylosing spondylitis, which affects the spine.
During the day, your joints are lubricated by fluid as you move around. At night, however, this lubrication slows down and joints may swell up15. Joint pain at night often feels achy, sore or stiff, creating a burning or throbbing sensation16.
Severe headaches such as migraines or cluster headaches can occur at night. Less frequently people may experience hypnic headaches, also known as ‘alarm clock headaches’. These tend to be more common in people over 50 years old, and often wake sufferers up at roughly the same time every night17 - hence the name.
Tips For Treating Pain At Night, And Getting A Better Night’s Sleep
It’s important not to feel hopeless if you have “painsomnia”. The good news is there are plenty of ways to treat pain at night, and these can hopefully make it easier to get more, better-quality sleep.
- Relaxation techniques – simple, slow, deep breathing exercises are some of the easiest ways to try and combat pain-related insomnia – especially for headaches. Other methods include visualization exercises, or progressive muscle relaxation18. You may also find that, for arthritis, physical exercises can help
- Regular sleep schedule – try going to bed at the same time every night, and rising at the same time every morning, no matter how disrupted your sleep is. This can help set your internal body clock, maintain healthy circadian rhythms and enhance your natural sleep drive19
- Eat foods that promote sleep – consuming certain foods can increase levels of tryptophan in the body, a protein that helps produce the sleep-regulating hormone serotonin. There is evidence that particular whole foods affect sleep. For example, milk, fatty fish, cherries, and kiwis have been associated with beneficial effects on sleep outcomes.20
- Mattresses and pillows – try to avoid putting pressure on your joints by ensuring your mattress and pillows are neither too soft nor too hard. Consider investing in mattresses with added support, or orthopaedic pillows
- Combined sleep aids/pain drugs – TYLENOL® PM contains a pain reliever and a sleep aid, helping to temporarily relieve minor aches and pains with accompanying sleeplessness when used as directed. Simply Sleep caplets and Extra Strength caplets could be a useful option for sleep and pain respectively for those with certain underlying conditions, including high blood pressure
Studies suggest that people living with rheumatoid arthritis often lack vitamin D, leading to chronic pain. Taking vitamin D as a supplement may therefore help combat joint pain at night21. Omega-3 meanwhile can help block fatty acids and proteins that result in inflammation22.
Over-the-counter (OTC) pain reliever/sleep aids such as TYLENOL® PM can temporarily alleviate minor aches and pains with accompanying sleeplessness when used as directed, while certain prescribed steroids may help with arthritis symptoms. You could also try supplements like fish oil23. Remember to consult with a medical professional to see what products might be appropriate for you.
Arthritis symptoms often develop over time, but sometimes occur suddenly. The typical age for the development of rheumatoid arthritis is between 30 and 60 years of age24.
Osteoarthritis, meanwhile, usually develops in people over the age of 5025
Sometimes pain at night can be a sign of a more serious medical condition. Be sure to contact your doctor if you are concerned, or if symptoms suddenly get worse.
1. Painsomnia. https://www.sleepfoundation.org/physical-health/painsomnia
2. Pain and Sleep. https://www.sleepfoundation.org/physical-health/pain-and-sleep
3. The Role of Cortisol in Sleep. https://www.naturalmedicinejournal.com/journal/role-cortisol-sleep
4. Slide show: Sleeping positions that reduce back pain. https://www.mayoclinic.org/diseases-conditions/back-pain/multimedia/sleeping-positions/sls-20076452?s=3
5. Musculoskeletal Pain. https://my.clevelandclinic.org/health/diseases/14526-musculoskeletal-pain
6. The Best Temperature for Sleep. https://www.sleepfoundation.org/bedroom-environment/best-temperature-for-sleep
7. Symptoms-Multiple sclerosis. https://www.nhs.uk/conditions/multiple-sclerosis/symptoms/
8. Grabovac I, Haider S, Berner C, et al. J Clin Med. 2018;7(10):336. doi:10.3390/jcm7100336 . Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity https://www.mdpi.com/2077-0383/7/10/336
9. Temperature and sleep. https://health.clevelandclinic.org/why-is-neuropathy-worse-at-night/
10.Musculoskeletal System. https://my.clevelandclinic.org/health/articles/12254-musculoskeletal-system-normal-structure--function
11. Sleep Disturbances in Fibromyalgia Syndrome: Relationship to Pain and Depression. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691959/
12. Osteoporosis. https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
13. Cancer induced bone pain. https://www.bmj.com/content/350/bmj.h315.long
14. How To Keep Sore Hips, Knees and Shoulders From Ruining Your Sleep. https://health.clevelandclinic.org/how-to-keep-sore-hips-knees-shoulders-from-ruining-your-sleep/
15. Why Do I Have Knee Pain at Night? https://health.clevelandclinic.org/why-do-i-have-knee-pain-at-night/
16. Joint Pain. https://my.clevelandclinic.org/health/symptoms/17752-joint-pain
17. Hypnic Headache. https://pn.bmj.com/content/5/3/144
18. Relaxation Exercises To Help Fall Asleep. https://www.sleepfoundation.org/sleep-hygiene/relaxation-exercises-to-help-fall-asleep
19. Can You Change Your Circadian Rhythm? https://www.sleepfoundation.org/circadian-rhythm/can-you-change-your-circadian-rhythm
20. Frank S, Gonzalez K, Lee-Ang L, Young MC, Tamez M, Mattei J. Diet and Sleep Physiology: Public Health and Clinical Implications. Front Neurol. 2017;8:393. Published 2017 Aug 11. doi:10.3389/fneur.2017.00393
21. Assessment of Vitamin D in Rheumatoid Arthritis and Its Correlation with Disease Activity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812075/
22. Omega-3 fatty acids in inflammation and autoimmune diseases. https://pubmed.ncbi.nlm.nih.gov/12480795/
23. Supplement and Herb Guide for Arthritis Symptoms. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/supplements-and-vitamins/supplement-and-herb-guide-for-arthritis-symptoms
24. Rheumatoid Arthritis. https://my.clevelandclinic.org/health/diseases/4924-rheumatoid-arthritis
25. Osteoarthritis. https://www.arthritis.org/diseases/osteoarthritis
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