Could Poor Sleep Be Making Your Pain Worse?

Sleep Hygiene - August 2026

a woman sleeping in a bed with a white comforter

Whether you're managing ongoing pain or recovering from an injury, one night of poor sleep can change how much pain you feel the next day; even before anything else about your condition has changed. While asleep, the body repairs damaged tissue, regulates inflammation and supports both physical and mental recovery. Neglect sleep, and the process doesn’t just pause. Pain sensitivity increases, healing slows and staying active becomes harder.

Why Is Sleep Important for Recovery?

Most of your body’s daily growth hormone, which drives tissue repair, is released in deep sleep. Missing that window regularly slows down repair mechanisms regardless of how well you’re eating or rehabbing. REM sleep does separate work, processing pain signals and supporting cognitive recovery.

This is relevant because there is a bidirectional relationship between pain and sleep. Pain disrupts sleep and disrupted sleep lowers your pain threshold. Because of this, a bad night’s sleep can make tomorrow’s pain worse, which then makes tomorrow night’s sleep worse again. Sleep is also when the body regulates pro-inflammatory cytokines; poor sleep is linked to elevated inflammatory markers, which slows recovery and increases pain signalling.

How Can Poor Sleep Affect Pain?

Your brain has a natural pain-dampening system, and poor sleep directly impairs it. Over the long term, insufficient sleep lowers the amount of stimulus needed to trigger a pain response; so the same movement, pressure or activity that didn’t hurt a few weeks ago can start to feel painful even though the underlying tissue hasn’t changed. In addition to this, poor sleep drains energy and concentration capabilities, both of which are needed to stay consistent with rehab.

What Is Good Sleep Hygiene?

Sleep hygiene refers to all the habits and routines that promote consistent, restful sleep. Small changes to your daily routine can make a dramatic difference to not only your sleep quality, but also your recovery journey.

5 tips for better sleep:

Get bright light within an hour of waking - morning light exposure is important for anchoring your circadian clock. It sets a timer that causes your sleep hormones to release around 14-16 hours later.
Cool the room and have a hot shower 1-2 hours before bed - your core body temperature needs to drop to trigger sleep onset. Having a hot shower or bath 1-2 hours before bed can help by dilating your blood vessels which dump heat afterward. Counterintuitively, your core temperature will drop faster once you get out, giving a larger ‘cooling signal’ to your brain than a lukewarm shower would.

If you’re not asleep in around 20 minutes, get back up - lying in bed awake teaches your brain to associate the bed with wakefulness rather than sleep. Get up, do something in dull light and only go back once you feel sleepy.
Write a to-do list for tomorrow before bed - studies on cognitive offloading have found benefits to writing a list before sleep. The brain tends to hold onto unfinished and future tasks, so writing a list offloads the apprehension loop.
Participate in regular exercise earlier in the daytime - regular exercise will support sleep quality, however vigorous exercise too close to bedtime can be too stimulating.

If pain is regularly disrupting your sleep, it’s worth raising with your physiotherapist directly. Untangling which is driving which (pain disrupting sleep, or poor sleep amplifying pain) often changes how your treatment plan is structured.

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