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How to Effectively Manage Painsomnia

Managing PsA

January 31, 2024

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Photography by Maskot/Getty Images

Photography by Maskot/Getty Images

by Hannah Shewan Stevens


Medically Reviewed by:

Nick Villalobos, MD


by Hannah Shewan Stevens


Medically Reviewed by:

Nick Villalobos, MD


Experts share tips for handling painsomnia and reducing its effect on your daily life.

All people with insomnia know the agony of a sleepless night, but only people living with chronic pain understand the excruciating frustration of “painsomnia.”

This phenomenon occurs when pain suppresses the body’s ability to sleep, leaving people with chronic pain in limbo, waiting to see whether exhaustion or torment will win the night.

Those dealing with the day-to-day effects of psoriatic arthritis will probably know this fickle friend a little too well.

Still, there are plenty of ways to effectively manage painsomnia, no matter the type or cause of the pain in question.

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What is painsomnia and why does it happen?

“Painsomnia is when pain makes it difficult to fall asleep and/or stay asleep,” said sleep expert Max Kirsten.

Long-term chronic pain generally triggers this blight. Sometimes the effect is minor, and painsomnia may only crop up occasionally, but other times, the problem becomes as chronic as the cause itself.

“The relationship between chronic pain and sleep is intricate and multifaceted, influencing various physiological and psychological processes,” explained Dr. Alka Patel, a general practitioner, sleep expert, and longevity expert based in the UK.

“Chronic pain disrupts sleep architecture, leading to fragmented and less restorative sleep.”

Chronic pain also makes it difficult to reach the deep stages of sleep, meaning the body gets stuck between being fully awake and fully at rest.

“Pain signals can also trigger the body’s stress response, leading to increased arousal and alertness,” added consultant neurologist Dr Steve Allder.

“This heightened state of arousal makes it challenging for individuals with chronic pain to achieve a relaxed and calm state conducive to sleep.”

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Measuring the effects of painsomnia on the mind and body

“The effect of poor sleep on overall health is substantial,” said Kirsten. “Chronic sleep deprivation is associated with a range of health issues, including impaired cognitive function, mood disorders, a weakened immune system, an increased risk of chronic conditions, and an overall decreased quality of life.”

One bad night’s sleep can be enough to affect your whole week, so when it becomes chronic, the effects are numerous.

Plus, insomnia is one thing, but waking up after a night of painsomnia, still in pain, is like experiencing a whole new realm of exhaustion.

The side effects of low quality sleep include:

  • cognitive impairment characterized by lack of concentration, memory lapses, and impaired decision-making skills
  • hormonal imbalances
  • reduced longevity over time, affecting lifespan and overall health
  • weakened immune system
  • higher risk of developing diabetes
  • difficulties managing weight
  • increased chance of developing cardiovascular disease
  • increased susceptibility to depression and anxiety

The effect painsomnia has on the mind worsens the perception of pain. Essentially, the more tired you are, the more intense your chronic pain will feel. Symptoms of depression and anxiety also contribute to this.

Lifestyle changes

Tackling painsomnia starts with an inventory of your overall lifestyle to identify any necessary changes.

Every choice we make during the day affects our sleep quality at night. Start by establishing a consistent nighttime routine.

We often use our bedrooms and offices interchangeably, confusing the brain when we abruptly switch the lights off and expect sleep to arrive instantaneously.

Like when exercising the body, the mind needs suitable preparation for its next activity.

Try writing out a short checklist of activities to carry out before going to sleep every evening. These could be as simple as brushing your teeth and washing your face.

A couple of minutes of stretching and meditation can also help lead your body into a restful state conducive to rejuvenating sleep.

“Regular daily heart pumping exercise of 10–30 minutes duration helps with sleep at night by promoting the body to release relaxing chemicals,” added Kirsten.

Small changes like increasing exercise and water intake will not cure painsomnia, yet they’re crucial for building a solid foundation for restful sleep.

One golden technique that supports many people with chronic pain is mindfulness. Praised as a miracle cure, this technique is by no means the answer to all your prayers, but it can still make a huge difference if implemented as a permanent lifestyle change.

“Start small with something that feels attainable, like a short guided meditation,” said Gabrielle Juliano-Villani, LCSW, a burnout recovery coach.“

Add this to your nighttime routine so that your nervous system can begin to enter a state of relaxation to help you sleep. It’s important to remember that small changes lead to big responses in our nervous system and stress levels!”

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Managing and treating painsomnia

“Managing chronic pain and improving sleep quality often necessitate a holistic approach that addresses both the underlying pain conditions and sleep disturbances to break this challenging loop,” said Patel.

Commonly, people with painsomnia seek out advice and only find resources for people with insomnia, which rarely accommodate the different needs of chronic pain patients.

When building a management plan, adapt as you go to figure out how coping mechanisms can fit your specific needs.

“Common advice for improving sleep, such as ‘create a quiet environment’ does not help people with chronic pain, as the lack of noise or distraction increases their perception of pain,” said Kirsten.

“Many patients with chronic pain perform a mental scan of their bodies regularly, and this hyper-focus on the ankle pain or back pain worsens the pain intensity because what we focus on expands.”

To avoid getting lost in the physical overwhelm, try sleeping with calming music or lights to soothe the mind as you move through the pain.

Calming techniques found in cognitive behavioral therapy (CBT) and meditation practices are also helpful, particularly because fear and anxiety increase or spread painful sensations.

“To treat pain, we have to stop the thoughts and behaviors that make it worse and employ strategies that help restore the nervous system, decrease pain, and improve sleep, such as relaxation strategies and changing our attitude from helplessness to focusing on what we can manage,” Kirsten said.

Reaching out

Painsomnia is unlikely to disappear overnight, so communication is key.

“Because painsomnia can affect all aspects of daily life, including cognitive performance, mood, mental health, immunity, work productivity, social functioning, and general quality of life, it’s important to be open about your experience so your loved ones understand what you are living with,” said Allder.

“Explain the concept and how it is affecting you, including daily challenges; be honest about your limitations; and don’t be afraid to ask for help and support,” he added.

Medically reviewed on January 31, 2024

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About the author

Hannah Shewan Stevens

Hannah Shewan Stevens is a freelance journalist, speaker, press officer, and newly qualified sex educator. She typically writes about health, disability, sex, and relationships. After working for press agencies and producing digital video content, she’s now focused on feature writing and on best practices for reporting on disability. Follow her on Twitter.

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