Health and Wellbeing

The connection between sleep and pain

Feb 26 2021

We all know that a great night’s sleep helps us to feel good and perform better. But did you know that there is a strong relationship between the quality of sleep and how you experience pain?

In this blog physiotherapist James explains their connection and shares his top tips for creating a healthy sleep schedule.

The role of the physio

If you’ve ever consulted a physiotherapist, you’ll know that we address several components of an injury and help with pain relief, recovery, rehabilitation and injury-proofing. We always look at physical aspects but realise that psychological and social factors can have a very strong influence on how you experience pain. One of these factors is sleep.

What’s sleep got to do with it?

There’s a good reason we ask about sleep. Evidence shows that those in pain generally do not sleep well and those who do not sleep well are prone to developing pain. However, experts are still uncertain about the exact reason for the connection.

There is also a strong link between a lack of sleep and other aspects of our health. Research has shown links between getting less than seven hours of sleep and an increased incidence of cardiovascular disease, obesity, diabetes, anxiety and depression.

Sleep and the cleansing of brain and body

One thing we do know is that sleep is hugely important for the ‘cleaning’ of the brain and body. Whilst our bodies rest, our lymphatic system works hard, acting as the ‘sewer system’ of the body. Waste products accumulate in the body during everyday tasks and these are transported and removed by the lymphatic system. In our brain, however, the process is much more complicated. New research has highlighted a special waste removal system in the brain – the glymphatic system. This is up to 60% more effective at waste removal when we are asleep than when we are awake.

Sleep and hypersensitivity

Bearing this in mind it is understandable why sleep-deprived people often feel worse than those who are well-rested. It could also be a reason why, according to recent research, sleep deprivation increases sensitivity to pain. It also makes us hypersensitive to activities that may not usually cause pain. This hypersensitivity could exacerbate symptoms of persistent and non-specific pain, such as neck pain and lower back pain. It follows that this may be one of the causes for the persistence of pain in the first place.

The benefits of sleeping well

The argument for the importance of sleep doesn’t stop there. Studies suggest that inadequate sleep impairs maximum muscle strength, athletic performance, concentration, mood and bone health. A large comparative study completed in 2018 by Bonnar et al tested athletes in a range of skill sets. It concluded that performance and general health in the general population were both improved with between seven and nine hours of sleep per night. However, in the athletic population, the benefits were much higher in those sleeping for up to ten hours per night.

It is clear that getting a good night’s sleep is of prime importance for recovery when you are injured. Furthermore, by improving your sleep quality and quantity, you can reduce your risk of injury.

Sleep hygiene

To help improve your sleep, here are some top tips for an effective, healthy sleep schedule:

Pick a bedtime and a waking time. Select a timeframe that gives you the best sleeping time you can achieve and do your best to stick to it, even during weekends and holidays. Your brain releases hormones to induce tiredness and prompt sleep; if you keep a regular schedule, you’ll find that you’ll begin to get tired at the opportune time for successful sleep.

Avoid caffeine, alcohol or nicotine for one to two hours before your planned bedtime.

If you’re unable to get to sleep within fifteen minutes of laying down, don’t just lay there. It’s better to get up and do a mundane task such as walking, listening to calm music or easy reading. This will allow your brain to wind down and prepare for sleep.

Optimise your environment. Ensure your bedroom is as dark and as quiet as it can be, find the position which is most comfortable for you and ensure you’re at a comfortable temperature. If needed, use earplugs or an eye mask.

Avoid overuse of your phone or tablet before bed. If you do have to use them then enable a night mode. Night mode reduces the brightness of the screen, in particular blue light, which is known to disrupt the regulation of melatonin, the hormone that helps you fall asleep.

If you're struggling with aches and pains that you can't seem to shake, we're here to help.