We’ve all been there at some point. Whether you’re suffering from a chronic condition or recovering from an illness or injury, your pain just seems to get worse at night. Nowadays, researchers have nicknamed this condition “painsomnia.” In fact, it’s common in people with chronic pain conditions including fibromyalgia, arthritis, and other chronic health conditions

In some cases, this increased pain may cause additional discomfort, while in others, sufferers are unable to fall or stay asleep because of the pain. We’ll dive into what makes the pain worse at night and some of the steps you can take to get a better night’s sleep. 

1) You’re Less Distracted at Night

Our minds play a huge role in our perception of pain. During the day, people are typically consumed with everyday activities including work, school, and hobbies. At night time, when these distractions are removed and you’re lying in the dark, it’s easy to concentrate solely on the pain symptoms you may be experiencing. 

This acute pain may move to the front of your thoughts, not only making it difficult to ignore but also causing additional stresses that prevent you from sleeping. This creates a vicious cycle of stress, pain, and insomnia that can further worsen your chronic condition. 

2) External Factors Create Additional Pain 

The pain you experience, however, isn’t solely in your mind. Additional factors at night can exacerbate the discomfort you may be feeling. For example, research has shown the effect that cold temperatures can have on arthritis and joint pain. The same neural receptors that respond to temperature changes also trigger pain. So it’s natural for your body to interpret these sensations as additional pain. 

pain worse at night

Moreover, other things in the atmosphere such as perfumes, dust, and pollen can worsen respiratory conditions and sleep problems such as sleep apnea. Likewise, as you rest, your breathing becomes slower, increasing the amount of carbon dioxide in your bloodstream. This increase in CO2 levels dilates your blood vessels, making nerve endings more sensitive. 

3) Body Pressure 

As you move around during the day, your body circulates fluids. At night, since you are less mobile, your joint linings can become congested with excess fluid, causing swelling and additional pain. This pain is sometimes strong enough to wake up people suffering from joint problems. Combined with high levels of stress, your immune system’s response can further aggravate symptoms. 

Ultimately, it’s likely a combination of all three of these factors making your pain worse at night. 

How Can You Reduce Pain at Night? 

Naturally, you should stick to whatever treatment strategy your doctor prescribed for you. However, there are some specific steps you can take to reduce pain and get a better night’s sleep, especially if you suffer from a sleep disorder: 

1) Practice Sleep Hygiene 

Whether or not you have chronic pain, healthy sleep habits are the key to a good night’s rest. Try to go to bed and wake up at the same time each night and morning. In addition, shut down all electronics at least 30 minutes before bed. 

Don’t eat or exercise 1-2 hours before you sleep. Finally, keep your room comfortable and dark and minimize any environmental factors that may disrupt your sleep. You can even take this one step further by creating a sleep routine before bed. This can include putting on soothing music, reading a book, and creating a rhythm that signals to your body that it’s time to sleep. 

2) Exercise is Essential 

Exercise is key to a good night’s sleep. Depending on your condition, you may be limited in your mobility, so discuss what types of exercise are safe for you to do. But try to get at least some moderate level of exercise each day to prevent insomnia and improve sleep. You’ll also have a boost of endorphins, which will help reduce your overall pain. 

3) Utilize Mental Techniques Like Meditation and Deep Breathing

pain worse at night

Since the perception of pain is so much higher at night, it helps to develop techniques like meditation or deep breathing to help lower your perception of pain. These techniques will take your mind off the pain, and relax you enough to help you fall asleep. It can be as simple as the old classic of “counting sheep”. Or, you can try to picture calm, relaxing places in your mind. 

4) Cold and Hot Therapy 

You can fight the effects of temperature on your body by taking a warm bath before bedtime, using a heating pad, or icing swollen areas. This can also be a part of your sleep routine to help you unwind. 

5) Look into Herbal and Natural Remedies 

There are a wide variety of herbal remedies that can help you sleep better. Get your doctor’s permissions and see if things like melatonin or herbal teas are okay for you. You can also use lavender sprays and aromatherapy candles, which help promote relaxation and tranquility. 

6) Review Medication Options With Your Physician 

If “painsomnia” has begun to seriously disrupt your ability to sleep and function in daily life, talk to your doctor about your symptoms. It helps to keep a journal to help track the severity of your symptoms and how much you’ve been sleeping each night. This will help your doctor find the right medications and pain management strategy for you. 

Overcome Pain That’s Worse at Night

There’s nothing worse than trouble sleeping. Sleep deprivation prevents our bodies from getting the essential rest they need to help us recover and manage our chronic conditions. Oftentimes, perception of pain is worsened because of the reduced distractions at night time. In addition, environmental and other factors also play a significant role in the way we experience pain. 

However, you can get a good night’s sleep. Begin by practicing good sleep hygiene techniques combined with exercise and stimulating activities. Keep track of your sleep patterns in a journal. This will help your doctor understand your chronic condition and sleep habits better so they can work with you to find the right strategies and medications you need to get you the rest you deserve. 

This article was updated in August 2019. 

How do you manage pain worse at night?

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14 COMMENTS

  1. Very interesting. Why don’t most or all doctors know this?? When asked why pain is worse at night, most of them just have a blank look, as if they are thinking about cleaning out the trunk of their car and realizing they never check the spare tire.

    • Lee,

      Thanks for taking the time to leave a comment. Managing chronic pain often takes a comprehensive approach, as things like diet, exercise, mindset and so many other factors can contribute to your pain. Doctors are trained to follow a procedure – diagnose an illness and prescribe a solution. Doctors are human, and one doctor might not necessarily have the same knowledge as a doctor that practices down the street.

      We are glad that you found this information to be helpful, and our goal is to provide you with information and tools that you can use in addition to what you are working on with your primary care doctor. That being said, it is important that you’re getting the best care and all of your questions answered by your primary care doctor. If you don’t feel that your needs are being met, don’t be afraid to go in with a list of questions and make sure they get answered. If you’re not getting the help you need, don’t be afraid to seek out a new doctor. This is your life, and it’s important that you get the care that you need.

      Thanks,

      Your Friends at Pain Resource

    • Aaron,

      Many people report a change in symptoms with the changes in position of the moon. If you’d like to collaborate with others who are also working to manage their pain, we welcome you to join our community by visiting forum.painresource.com.

      Wishing you the Best,

      Your Friends at Pain Resource

  2. My pain is definitely worse with extreme changes in weather, like a storm front moving in or when the temperature one day is drastically different than the next. I live in Alabama where this time of year we may be in the 30’s one day, and a day or two later be in the 60’s. When this happens I always hurt more. I also noticed that I got a migraine anytime it rained, I thought I was a little crazy but one day mentioned it to my neurologist. He said it is actually common to get headaches when the barimetric pressure changes and that there is medication for it. I now always take “weather pill” anytime there is rain in the forecast.

  3. I jammed my shoulder mid December , recovery plateaued around end of Feb & I still have pain part way through the night. I can relieve it by pressing on various spots which are sore to touch but get best relieve with a cold pack. Anti inflammatories do nothing. Best treatment ?- Massage ? light exercise ?

    • Hi Dave,

      Thanks for your comment. I’m sorry to hear that you’re still experiencing pain. First and foremost, I would recommend consulting with your doctor. Additionally, many people with this type of pain have experienced relief from deep tissue massage therapy and yoga. I would be very careful doing upper body exercises, which might cause injury if the area is already tender. One massage therapist recommended to me to put a tennis ball in a long sock, and throw it over your shoulder and roll it over the tender area while sitting in a comfy chair. I hope these tips help and that you start to find some relief soon.

      Thanks,

      Maren

  4. I was so glad to find this site. I am on Oxycodone and only 2 per day(5 mg). I split 1 pill in half to help through out the day and save the whole pill for night. Sadly they only last a few hours (3 to 4) so that leaves a lot of in between time with pain. I have a curved spine at the neck with dead blocks and a pinched nerve that has settled mostly in hands and arms. I also have DVT in my left leg. Anyway, I have tried deep breathing and practice different sayings to help me relax. The pain cause anxiety and so on. Trying a new way through lite exercise and music. Thanks Again

  5. Since they cut off meds for pain I’ve noticed pain at night is at its peak. Immanrancher I would put cow down with this’s kinda pain. Dpoesntnmaensen

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