Pain is an unpleasant feeling (sensation) that you experience when nerve receptors in your body send a signal to your brain that something has happened or that something is wrong. Pain can be classified as acute or chronic. Acute pain lasts for a short time e.g. a broken bone that eventually heals. Chronic pain refers to ongoing (recurring) pain that lasts for longer than a few months e.g. lower back pain, recurrent headaches, fibromyalgia, arthritis or cancer pain. When pain occurs at night, it can interfere with your sleep.3

The relationship between pain and sleep2

Pain affects sleep2
Chronic pain can lead to longer sleep onset (the time you take to fall asleep), more frequent and longer awakenings after sleep onset, shorter total sleep time and poorer sleep quality – all characteristics of insomnia.2

Sleep affects pain2

Research has shown that insomnia is a significant risk factor for the development or maintenance of pain symptoms.2

Insufficient sleep or sleep deprivation can affect the neurobiological systems that modulate pain in your body by reducing your brain’s capacity to inhibit pain (analgesia), or by increasing your sensitivity to pain. Short sleep times, fragmented (interrupted) sleep and poor sleep quality can often cause next-day hypersensitivity to pain (or lower pain threshold) in conditions like rheumatoid arthritis. Short or disturbed sleep can lead to the development or worsening of sudden (spontaneous) pain symptoms (e.g. muscle pain, headache). Among people with chronic pain, insomnia symptoms are associated with greater pain intensity, pain-related disability and depression.1,3,7

The link between the severity of insomnia symptoms and the perception of pain1

A recent study, that made use of a screening tool called the Insomnia Severity Index (ISI), showed that participants reported having more pain than usual after they experienced a particularly bad night’s sleep (reflected as higher ISI scores) and less pain than usual after they experienced a particularly good night’s sleep. Similarly, participants reported having significantly worse sleep than usual following a day during which they experienced more pain than usual. They also reported having significantly better sleep than usual following a day during which they experienced less pain than usual.1 You can read more about the Insomnia Severity Index in this booklet8

Sleep can be a “pain-killer”4

Researchers have concluded that improving sleep and sleep quality may be important for the management of pain hypersensitivity, which could potentially lead to pain reduction. Speak to your doctor if you need help with sleep and pain management. They may be able to recommend additional therapies or prescribe medication to help you sleep better.3,4


We’ve created a booklet filled with useful tips to help you manage your insomnia.8

In preparing this article, every effort has been made to provide an objective overview. The content contained in this article contains medical or health sciences information as per cited articles for public information. The content of this article has been initiated and is brought to you by Sanofi South Africa.

  1. Wei Y, Blanken TF, Van Someren EJW. Insomnia really hurts: Effect of a bad night’s sleep on pain increases with insomnia severity. Front Psychiatry 2018;9(377):1-8.
  2. Tang NKY. Insomnia co-occurring with chronic pain: Clinical features, interaction, assessments and possible interventions. Rev Pain 2008;2(1):2-7.
  3. Pacheco D, Rehman A. Pain and sleep. 23 May 2023. Sleep Foundation. Available online at [Accessed 17 August 2023].
  4. Nijs J, Mairesse O, Neu D, et al. Sleep disturbances in chronic pain: Neurobiology, assessment, and treatment in physical therapist practice. Phys Ther 2018;98(5):325-335.
  5. Brooks L. Painsomnia: Insomnia caused by pain. 07 August 2023. Verywell Health. Available online at [Accessed 17 August 2023].
  6. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: An update and a path forward. J Pain 2013;14(12):1539-1552.
  7. Haack M, Simpson N, Sethna N, et al. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology 2020;45:205-216.
  8. Tips to help you overcome insomnia and get the sleep you need. Patient resource. Sanofi. MAT-ZA-2100751-1.0-07/2021.