Sleep and Chronic Pain – Occupational Therapy

Sleep and Chronic Pain

Overview

Sleep is fundamental to health and well-being, especially for individuals living with chronic pain. This document looks at the relationship between sleep and pain, principles for healthy sleep, and practical strategies for improving sleep quality.

Sleep & Chronic Pain: The Connection

• Prevalence: 44–88% of people with chronic pain experience sleep disturbances. At least half of those with insomnia report chronic pain.
• Bidirectional Relationship: Poor sleep can worsen pain, and chronic pain can disrupt sleep. Addressing sleep issues can reduce pain intensity and improve overall outcomes.

How Much Sleep Is Enough?

• Sleep needs vary widely (4–10 hours/night is normal) and change with age, lifestyle, and health. Broken sleep is common; long daytime naps may affect nighttime sleep quality.

Benefits of Sleep

• For the Body: Supports heart, metabolism, immune system, hormones, and body temperature.
• For the Mind: Enhances mood, memory, focus, creativity, and decision-making. Sleep helps the brain clear out waste and restore energy.

Principles of Healthy Sleep

Based on the work of Colin Espie, Professor of Sleep Medicine, five principles guide good sleep health:

• Valuing: Recognise sleep’s importance
• Prioritising: Make sleep a priority.
• Personalising: Tailor sleep habits to individual needs.
• Protecting: Guard your sleep from disruptions.
• Trusting: Trust your body’s natural sleep rhythm.

You can watch a video clip on the 5 principles here:

The 5 Principles of Good Sleep Health (opens in a new tab)

LET IT BE!!

Practical Strategies

• Routines: Maintain consistent sleep/wake times, limit naps to 20 minutes, get daylight exposure, and create a soothing sleep environment.
• Lifestyle: Consistent exercise, avoid stimulants (caffeine, nicotine, alcohol) before bed, and eat a balanced diet.
• Personalisation: Experiment with sleep timing and duration to find what works best for you. Identify if you’re a “night owl” or “morning lark”.
• Trust & Protect: Don’t force sleep; let it come naturally. Avoid over-analysing sleep data and be kind to yourself if you struggle. Use sleepiness as a cue for bedtime.

Techniques to try:

• Structured relaxation (deep breathing, progressive muscle relaxation) and mindfulness to calm the nervous system and manage pain responses.
• Thought blocking (e.g., repeating the word “the” in your mind) to quiet mental chatter.

Medication Overview – always consult with your GP or the pain nurses.

• Melatonin: Regulates sleep timing but has limited impact on sleep quality or duration. Effects are modest and vary between individuals. Lifestyle factors often override its benefits.
• Zopiclone: Boosts GABA to calm the brain and aid sleep, but long-term use can lead to tolerance, dependence, and side effects (drowsiness, dry mouth, headache, mild memory issues).

Resources

• Sleep diaries and further information are available from
• The Sleep Charity (opens in a new tab)
• Live well with pain - sleep planner (opens in a new tab)

ACTION: What strategies will you use to help you with sleep?

• Valuing, ​ prioritising, ​ personalising,​ protecting and trusting sleep.