The good news is that the link works both ways. Improving sleep, even a little, can make pain more manageable.

Key points

• • Pain disturbs sleep, and poor sleep makes your body more sensitive to pain.
  • Consistent sleep habits and a calm wind down routine help more than most people expect.
  • Sleeping tablets tend to lose their effect over time and can be habit forming.
  • Some pain medicines can affect breathing during sleep, so tell your doctor if you snore heavily or wake gasping.

How do pain and sleep affect each other?

Pain makes it harder to fall asleep, harder to stay asleep, and harder to reach the deeper stages of sleep that leave you feeling rested. Getting comfortable in bed can be difficult, and small movements during the night can wake you.

At the same time, poor sleep makes the nervous system more sensitive, so the same level of pain feels stronger after a bad night. Tiredness also lowers mood and patience, which makes pain harder to cope with. Over weeks and months, this becomes a cycle that is hard to escape without tackling both sides.

What can I do tonight to sleep better with pain?

Small, consistent changes work best:

• • Get up at the same time every day, even after a poor night.
  • Build a wind down routine for the hour before bed, such as dim lights, a warm shower and no work or news.
  • Try relaxation, slow breathing or a guided meditation once you are in bed.
  • Use pillows to support painful joints or keep your spine in a comfortable position.
  • Limit caffeine after midday and avoid alcohol close to bedtime.
  • If you cannot sleep after about 20 minutes, get up and do something quiet until you feel sleepy.

A podcast or calm music can also help by giving your mind something other than the pain to focus on.

Does the timing of my pain medicine matter?

It can. Some pain medicines last longer than others, and the time you take them affects whether you have cover through the night. Some cause drowsiness, which may suit the evening, while others can make sleep lighter or more broken.

If pain is waking you at the same time each night, or you feel groggy every morning, ask your doctor or pharmacist whether the timing or type of your medicines could be adjusted. Do not change doses or timing on your own.

Are sleeping tablets a good idea?

Sleeping tablets can help for a short period, such as a few nights during a flare. Over longer periods, they tend to stop working as well and can be habit forming. They are also risky alongside opioids and some nerve pain medicines, because the drowsiness adds together.

For ongoing sleep problems, the most effective long term treatment is cognitive behavioural therapy for insomnia. It is a structured program that retrains sleep habits and thoughts about sleep, delivered by a psychologist or through online programs. Ask your GP whether it could suit you.

When should I see my doctor about sleep?

See your doctor if you snore loudly, wake gasping or choking, or feel very sleepy during the day. These can be signs of sleep apnoea, a condition where breathing repeatedly pauses during sleep. It is more common in people taking opioids long term, and it is very treatable.

It is also worth a visit if poor sleep has lasted for months, if your legs feel restless at night, or if your mood has been low. Each of these can be treated, and treating them often helps pain too.

How Ace can help

Ace pharmacists can look at when you take each of your medicines and whether any might be working against your sleep, flag combinations that raise night time risks, and talk through possible changes with your doctor. Get started with Ace.

References

Sleep Health Foundation. Pain and sleep.

healthdirect. Taking opioid medicines safely.

healthdirect. Chronic pain.

Agency for Clinical Innovation, Pain Management Network. Chronic pain.

This article is for general information only and does not constitute medical advice. Talk to your doctor before changing any medicine or starting a sleep treatment.