How To Sleep Better When You Have CRPS or Chronic Pain

Struggling to Sleep with Chronic Pain? Try these 14 Top Tips

We know that sleep is integral to our lives, and establishing good sleep practices is crucial. But when you live with chronic pain or conditions like Complex Regional Pain Syndrome (CRPS) it often leads to sleepless nights, and trying to find a comfortable position to sleep can become a constant struggle. Equally lack of sleep then causes us to be more sensitive to pain.

In this article we look at the link between chronic pain and sleep as well as giving you 14 practical tips from the chronic pain community, to help you get a better sleep. 

Sleep as we know is critical for many things especially restorative sleep — which comprises of the completion of all five stages of sleep — is important for brain function. (The Circle Group 2023)

Do you notice when you have a sleepless night that you may feel angry or irritable? This is because the restorative sleep also helps to regulate your emotions, showing you that you haven't had sufficient sleep.

Chronic pain does and can have a significant impact on sleep. This is because when you have chronic pain your nervous system is more active, which will then interfere not only on how quickly you can fall asleep but also how deep your sleep is. (Please read our article on Rapid Eye Movement (REM) Sleep).

For some people, sleep comes naturally, but for others it can be difficult to fall asleep and can cause frequent wake-ups during the night, making it harder and harder to reach the deeper sleep stages.

Does lack of sleep make chronic pain worse?

Researchers have found that the most common issue facing people living with chronic pain fragmented sleep or short sleep times, which then heightens the pain sensitivity on the following day. (The Sleep Doctor 2023)

People who have insomnia due to chronic pain or difficult sleeping because of chronic pain do have  ore severe pain.

What is Painsomnia?

Many of you living with chronic pain may know the phrase "Painsomnia" which is the phrase given by people who live with chronic pain referring to the difficulty in sleeping due to chronic pain. It is now also used to describe the vicious cycle of chronic pain and disturbed sleep. 

Is Painsomnia Real?

Although Painsomnia isn't officially recognised by the medical professionals, it's definitely recognised by those people living with pain. Many pain patients believe it's a better term than 'insomnia'.

To improve sleep quality with CRPS, it is important to develop good sleep habits that go beyond using technology. One way to do this is by creating a relaxing bedtime routine. It is also important to understand the connection between pain and sleep. Additionally, trying different methods without relying solely on digital devices is key.

Why is it difficult to sleep when you have chronic pain?

Living with chronic pain, particularly CRPS, brings with it various challenges in maintaining consistent and restorative sleep. An overactive nervous system, pain-induced stress, and sleep problems create a cycle that needs careful intervention.

Here are some reasons why it can be difficult to sleep when you have chronic pain:

• There are no other distractions going on unlike during the day
• You may worry about your lack of sleep or poor sleep and how that's going to affect you the next day,
• You may be uncomfortable in your bed
• You may be disturbed by lights and sounds from outside
• Your medication may make your drowsy during the day you have an irregular sleeping pattern
• Hormones may be a big factor because it is when cortisol (the anti-inflammatory jhormose) is at its lowest 

Various research studies have highlighted the prevalence of sleep complaints within chronic pain disorders. Insomnia often goes hand in hand with chronic pain, so it's important to tackle sleep problems for overall health.

'Insomnia can lead to sleep deprivation, which increases the release of proteins called cytokines that are involved in the body's inflammatory response and makes people even more sensitive to pain.' (Solan, M. 2023)

14 Tips from the Chronic Pain Community to Help You Sleep When You Have Chronic Pain

1. Go to Bed Only When Tired: Respect your body's natural sleep cues, so if you're not tired then don't go to bed at that point. It's best to wait for when you do feel tired.
2. If Sleep Doesn't Happen, Take a Break: If you find you're not falling asleep in the first 15-30 minutes, then don't stay in bed. Instead get up and try doing a relaxing activity, or try some breathing exercises before attempting to sleep again. Practising relaxation techniques can be a real help for some people living with chronic pain. Read our article on Relaxation for Chronic Pain
3. Develop Distraction Techniques: By diverting your focus from your pain through planned distractions can be helpful when trying to get to sleep. Read our article on Distraction Techniques
4. Consistent Sleep Schedule: Reinforce your sleep-wake cycle with a routine. Make sure you go to bed and get up at the same time each day/night even on weekends. Having a regular sleep-wake routine will help you normalise your circadian rhythm and can improve your overall sleep quality. Your circadian rhythm is a biological cycle that runs approximately every 24 hours and regulate essential functions like yoir sleep, metabolism, and hormone release.
5. Make Mindful Food and Drink Choices: Avoid stimulants like alcohol, coffee or spicy foods, as well as limiting blue light which come from phones, tablets and TV's close to bedtime.
6. Create a Relaxing Bedtime Ritual: Try to start including some calming activities and mindfulness techniques approximately 30-45 minutes before you got to bed to start calming down your nervous system.
7. Soothing Aromas: Use scented candles, essential oils including lavendar, or incense in the bedroom to help you relax. Applying a couple of drops of essential oils to improve sleep on each of the sensory points or pulse point rollers, again on the sensory points namely wrists, back of neck, sternum and sides of the feet). When you put on the essential oils, just take a moment to be mindful and present. Think about how it feels, what can you smell and just enjoy the scent. 
8. Comfortable Sleep Environment: Consider your room temperature, darkness, and noise levels in your bedroom. Having the room dark can help produce melatonin secretion which is necessary for a good night's sleep. Keep your bedroom temperature at approximately mid 60 degrees to help promote a good sleep condition. Also consider your pillows, mattress and bed sheets. Finally try to avoid clutter and mess in your bedroom. Messy rooms can create anxiety which doesn't help sleep.
9. Limit Daytime Naps: This is to prevent interference with your nighttime sleep. If you feel tired during the day then try to limit your nap to approximately 30 minutes, napping for longer than this or napping within 6 hours of your usual bedtime can interfere with your night-time sleep.
10. Include Physical Activity: Foster better sleep with moderate daytime exercise, even a 20 minute walk during the day can help. But if you have chronic pain which impacts on your ability to exercise, try seated yoga exercises during the day.
11. Stress Management: Employ effective strategies to manage stress throughout the day. Stress is a natural response that the body creates to protect itself in dangerous situations. If you have stress, it doesn't help you to sleep well.
12. Limit Electronic Device Use: Reduce exposure to screens before bedtime, so turn off your screens or dim them to help you sleep at least 1 hour before you go to bed or are ready to sleep. However we know that many people with chronic pain use their phones or tablets to use sleep apps, music or audible books. So try and dim your screens so they're not as bright.
13. Medical Consultation: Seek professional advice if sleep troubles persist. If you are really struggling then please do speak to your Doctor to see if there's anything they can recommend
14. Journaling Benefits: Use a journal to organise thoughts, manage stress, or track sleep patterns. You could also create a sleep diary where you note down things like time you go to bed, how long approximately it takes you to fall asleep, what time you get up, any nightmares or night terrors and any other notes. This could then help your doctor if you need to seek medical help. Otherwise general journaling before bed can help. Check out our Self Care packs in our online shop as we have a section on sleep including a sleep tracker and sleep diary. We have a self care pack for adults, teens and children. Research has shown that journaling before you go to bed can reduce the time it takes you to fall sleep. Try writing down any worries you may have, any issues or problems you're struggling with, to-do lists for the next day or week. If you're struggling to find something to write, then try these night-time journal prompts to help get you started:

• What was your favourite part of today?
• What are you worried about?
• What tasks do you need to complete tomorrow?
• Describe in 2 words what your day was like
• What am I grateful for today?
• How am I feeling right now?
• What did I learn about myself today?
• Write one thing that made me feel loved today

Experiences from people dealing with CRPS and chronic pain in their daily lives provide further understanding, highlighting the importance of tailored sleep hygiene (habit) strategies including:

• Positive affirmations - read out 2 or 3 positive affirmations every night to reframe your thoughts to positivity instead of thinking you can't sleep
• Weighted blankets
• Lavender mists
• Cherry juice before bed
• Meditation including brain dump
• Count your breaths
• Relaxing soft music
• Aromatherapy
• No screen time!
• Bed products such as bed cradles to lift sheets off your lower body so nothing touches your CRPS areas, or body / pregnancy pillows 
• Reading relaxing (nothing too heavy) or Listen to Audible books to distract from the pain
• Don't clock watch! Turn down the screen brightness on your phone if you do check it for the time

As well as other soothing bedtime routines. What are your top tips?

By implementing these methods and tailoring them to your own needs, it can really enhance the quality of your sleep, improving your self management and an overall enhanced quality of life. It will take time to find what works for you and what doesn't, but it will empower you to reclaim a peaceful and refreshing night's sleep despite the difficulties and challlenges of chronic pain and CRPS.

Cited Resources

• Ancoli-Israel, S. (2006) “The impact and prevalence of chronic insomnia and other sleep disturbances associated with chronic illness,” American Journal of Managed Care, 12(8), S221. < Bolash, R. & Drerup, M. (2015) ‘How to Beat Insomnia When You Have Chronic Pain’ Cleveland Health Clinic. December 2015. Available from < https://health.clevelandclinic.org/managing-insomnia-for-those-with-chronic-pain/>
• Breus, M. (2016) ‘How To Create An Effective Bedtime Ritual For Better Sleep’ Sleep Doctor. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046588/ Jank, R et al. “Chronic Pain and Sleep Disorders in Primary Care.” Pain research and treatment vol. 2017 (2017): 9081802. doi:10.1155/2017/9081802
• Lewandowski, A.S. et al (2011) ‘Sleep Problems in Children and Adolescents with Common Medical Conditions,’ Pediatr Clin N Am 58 (2011) 699–713. doi:10.1016/j.pcl.2011.03.012
• Long, A.C. et al. (2008) ‘Sleep Disturbances in School-age Children with Chronic Pain,’ Journal of Pediatric Psychology, Volume 33, Issue 3, April 2008, Pages 258–268, https://doi.org/10.1093/jpepsy/jsm129
• Mayo Clinic (2014) ‘Sleep Tips: 7 steps to better sleep,’ Mayo Clinic website. 2014, June 9. Available from: http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep/art-20048379
• Moeller, A. (2016) ‘5 Little known Tips for Sleeping with chronic pain’ Spine Health. Available from: https://www.spine-health.com/blog/5-little-known-tips-sleeping-chronic-pain
• Queen West Physiotherapy & Acupuncture (2014) ‘Pillows – Happy Sleeping!’ Queen West Physiotherapy & Acupuncture blog. Accessed April 2020. Available from < https://www.queenwestphysio.ca/strategies/sleeping>
• Solan, M. (2023) 'Do we feel more pain at night?' Harvard Health - Pain. October 2023. Available at Harvard Health website.
• Tang, Nicole K Y. “Insomnia Co-Occurring with Chronic Pain: Clinical Features, Interaction, Assessments and Possible Interventions.” Reviews in pain vol. 2,1 (2008): 2-7. doi:10.1177/204946370800200102
• The Circle Group (2023) 'Painsomnia: techniques for falling asleep with chronic pain'. Accessed August 2024. Available from The Circle Group.
• The Sleep Doctor (2023) 'Pain and Sleep' Available from The Sleep Doctor website
• Zilca, R. (2014) “Three Bedtime Reflection Routines To Help You Sleep” Psychology Today. September 2014. Available from: < https://www.psychologytoday.com/gb/blog/confessions-techie/201409/three-bedtime-reflection-routines-will-help-you-sleep>