Do we feel more pain at night?

Approximately one in five adults in the United States suffer from chronic pain. Chronic pain is defined as pain that lasts for two to three months or longer, even after the original injury or illness has healed. Previous research suggests that the discomfort from chronic pain may get worse in the evenings, interfering with sleep.

Chronic pain can manifest in different ways, ranging from a dull ache to tingling, burning, or stabbing sensations. Additionally, it can affect specific joints, muscles, or certain regions of the body, such as the neck and back. In some cases, the condition may be more diffuse, as found in cases of arthritis or fibromyalgia. No matter the origin of the pain, it can have a significant impact on a person's daily life, making it difficult to complete everyday tasks. In those cases, treatment and pain management is often necessary to help the individual cope with the discomfort.

There are varying explanations for why the level of pain experienced in individuals with chronic pain can be higher at night. For one, nighttime is when the body's production of its anti-inflammatory hormone cortisol is lowest. Certain individuals may also experience heightened pain levels due to a circadian rhythm similar to that which controls the sleep-wake cycle, as suggested by recent studies. When this happens, it can lead to a disruption of sleep, as well as fatigue, which can leave people with chronic pain more sensitive to discomfort. This is further compounded by the fact that people with insomnia are more likely to experience chronic pain, as a lack of sleep can lead to the release of proteins called cytokines that contribute to the body's inflammatory response.

People with chronic pain can improve their sleep quality by following a pre-bedtime relaxation routine, such as taking a shower, doing stretches or yoga poses, or performing deep breathing exercises. It is also important to create a healthy sleep environment; make the bedroom dark and cool, and use comfortable pillows and supports. Additionally, reframing negative thoughts can help reduce stress and anxiety. Listening to soft music or counting one’s breaths can also help move the focus away from pain, relax the body, and induce sleep.

References

Solan, M. (2023, January 18). Do we feel pain more at night? Harvard Health. Retrieved January 24, 2023, from https://www.health.harvard.edu/blog/do-we-feel-pain-more-at-night-202301182877