What Is “Painsomnia”?

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

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.

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

Many different kinds of aches and pains can lead to “painsomnia”:

Nerve Pain

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

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

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

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.

Headaches

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.

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