Painsomnia: 8 Tips To Help You Sleep Better

Medically reviewed by
 Dr. Nayantara Santhi

Dr. Nayantara Santhi

Dr. Nayantara Santhi holds an academic position at Northumbria University. After completing her Ph.D. at Northeastern University (Boston, MA), she joined the Division of Sleep Medicine at Harvard Medical School as a post-doctoral fellow to research how sleep and circadian rhythmicity influence our cognitive functioning.

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Sleeping should be your time to heal, but sometimes pain can be so aggressive you can’t relax, even in bed. If you struggle with chronic pain to the point where…

Last Updated On March 15th, 2022
Painsomnia: 8 Tips To Help You Sleep Better

Sleeping should be your time to heal, but sometimes pain can be so aggressive you can’t relax, even in bed. If you struggle with chronic pain to the point where you’re unable to fall or stay asleep, you may have a condition called painsomnia. A lack of restorative sleep due to your pain only hinders healing and worsens pain.

While you should always speak with a medical professional for treatment, there are simple ways you can relieve your pain from home. We take a look into some of the changes you can make to improve your sleep quality and what painsomnia really is.

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1. Invest In a Better Mattress and Pillow

A bad mattress or pillows might be triggering or worsening your pain as they can throw your spine out of alignment, create pressure points, and cause muscle stiffness. Select a high-quality mattress and pillows with a firmness suited for your body weight and sleeping position.

Sleepers who weigh less than 130 pounds need a soft to medium-soft mattress, while sleepers weighing more than 230 pounds should use a medium-firm to firm mattress. Sleepers who weigh between 130 and 230 pounds can choose a mattress based on their sleeping position.

Back sleepers need a medium to medium-firm mattress to prevent sinking. If you’re a side sleeper, use a medium to medium-soft bed to prevent any pressure buildup on your hips and spine. And, while we don’t recommend stomach sleeping, especially when you suffer from pain and stiffness, a firm mattress keeps your spine aligned in this position and prevents lower back pain.

When it comes to pillows, side sleepers should choose one with a high loft (5 to 7 inches thick), back sleepers do best on medium-loft pillows (4 to 5 inches), and stomach sleepers have the option of choosing a low-loft pillow (3 inches or less) or no pillow at all.

2. Keep Your Bedroom Cool

Bedroom temperature affects your sleep quality, both in how quickly you fall asleep and how long you stay asleep. Your body temperature naturally drops when you sleep and keeping your room cool helps you drift off sooner. For high-quality sleep, the optimal bedroom temperature is between 60 to 67 degrees Fahrenheit. Dr. Nayantara Santhi explains, “Temperature and light play a key role in your sleep-wake cycle. A comfortable neutral room temperature will go a long way in helping you fall asleep. Keep your room at a cool temperature. Light, even 10 lux, will suppress melatonin in the evening making it harder to fall asleep.”

3. Try Hot and Cold Therapy

Before bed, hot and cold therapy can provide localized pain relief to your muscles and joints. A warm bath or a cold compress can reduce inflammation and stiffness. Heat therapy improves blood circulation to soothe pain, while cold therapy temporarily reduces circulation and nerve activity to relieve pain.

You can conduct hot and cold therapy solely in the evenings, or up to three times a day for fifteen to twenty minutes. Topical hot and cold treatments are a quick and easy option; some popular ones include heat pads, ice packs, or moist towels. However, steer clear of aggressive treatments, such as ice baths, as they shock your body and leave you alert.

4. Stick to a Sleep Schedule

A consistent sleep schedule normalizes your circadian rhythm and can improve your sleep quality. Follow a schedule that allows you to sleep between 7 to 9 hours nightly. Aim to wake up and sleep within 30 minutes of the same time every day, even on weekends, so your sleep pattern is regular.

In addition to a regular sleep schedule, maintaining a bedtime routine relaxes your body and signals your brain when it’s time to sleep. Try taking a bath, journaling, drinking non-caffeinated tea, or doing a skincare routine to wind down.

5. Don’t Linger in Bed

If you’ve been struggling to fall asleep for longer than 15 to 30 minutes, get up. Laying in bed, potentially frustrated or overthinking because you’re not falling asleep, won’t make you fall asleep any faster.

Instead, try washing your face with cold water, sit down in a chair, or take deep breaths until you get tired. During this time, avoid turning on bright lights if possible and don’t turn on any electronics, though using a dim lamp is fine.

Once you feel tired, get back into bed and try sleeping again.

6. Avoid Overstimulation

If you drink an afternoon cup of coffee or stay up late on your phone, sleeping may prove difficult.


It can be hard to limit caffeine when you’re constantly fatigued during the day, but your body will benefit from less caffeine when you fall asleep. Enjoy any caffeine in the mornings so your body can digest it before bedtime rolls around. Also, limit your intake to no more than 400 milligrams a day.

Next to caffeine, electronics are another stimulant and keep you awake longer than necessary. The blue light from your TV or phone screen suppresses melatonin release, so turn off your electronics 30 to 60 minutes before bed. Rather than watching a late-night movie or scrolling through emails, read a book or do a crossword puzzle instead.

7. Exercise During the Day

If your pain is not debilitating, daily physical activity can actually relieve your pain and strengthen your muscles. Exercise also increases joint and muscle mobility and relieves stiffness.

Try light aerobic exercises such as swimming, pilates, walking, and stretching so you don’t aggravate your body. However, if you’re unsure it’s safe for you to exercise, check with your doctor.

Also, avoid strenuous exercise late at night as the adrenaline and cortisol released during exercise can make falling asleep difficult.

8. Consider Cognitive Behavioral Therapy (CBT)

If your painsomnia is persisting, look into Cognitive Behavioral Therapy for Insomnia (CBT-I). The goal of CBT-I is to improve your ability to sleep well by changing your actions or mindset around sleep.

Your sleep therapist might suggest stimulus control therapy (only using your bed for sleeping), psychotherapy, or improving your sleep hygiene. However, treatment varies from person-to-person.

Pain is partially psychological, so CBT can help train you on how to respond to pain and your coping mechanisms. You can also learn how to better handle stress or any mental health conditions you’ve faced due to your painsomnia.

What is Painsomnia?

Painsomnia is a patient-generated term for sleep deprivation as a result of pain or chronic health conditions, such as fibromyalgia or rheumatoid arthritis. Roughly a quarter of people suffering from chronic pain have clinical insomnia, or painsomnia. The relationship between chronic pain and insomnia is likely bidirectional—the lack of sleep worsens pain, but the worsened pain further impairs sleep.

Painsomnia is characterized by an inability to get comfortable in bed due to pain, fall asleep and stay asleep, and frustration or stress about the lack of sleep. Poor sleep weakens the immune system, causes weight gain, worsens cognitive functions, and puts you at risk for conditions including certain cancers, stroke, and diabetes.


What are the three types of insomnia?

The three types of insomnia are:

  • Acute: Acute insomnia typically lasts for a few days or weeks and is also known as adjustment insomnia. It’s caused by outside stressors such as work, deadlines, and school, and passes once the stressor is gone.
  • Transient: Transient insomnia is most commonly caused by outside issues including environmental changes (jet lag or a timezone shift), stress, or mental health conditions. It typically lasts less than a week.
  • Chronic: If you have trouble sleeping three times a week for at least 12 weeks, you may have chronic insomnia. It might be caused by physical or mental health conditions, certain medications, or sleep disorders.

Why can’t I sleep even though I’m tired?

Insomnia can be triggered by numerous factors. You feel super fatigued but still can’t sleep because your brain is awake and active, potentially due to overthinking or stress.

If you, for example, are stressed about a test in the morning or a speech you have to give, you might be up for hours because your brain is wound up. Or, if you exercise late at night, the adrenaline and cortisol might be keeping you awake even if you’re tired.

Why does my pain get worse at night?

Pain can worsen in the evenings for multiple reasons. For starters, laying in one position may make your muscles and joints stiffen up and get sore. And, if your mattress and pillows are not supporting you properly, they can throw your spine out of its healthy alignment and cause pain.

Cortisol (an anti-inflammatory hormone) is also lower in the evenings, so you may experience pain more severely.

Another potential reason is your pain thresholds decrease at night. During the day, you’re distracted by external stimuli, but when you’re laying in the dark doing nothing, suddenly all you notice is your pain.

Can chronic pain go away on its own?

Chronic pain is any pain lasting longer than 12 weeks, or pain persisting after an illness or injury has passed. The pain may potentially pass on its own, but this is unlikely and you shouldn’t count on it.

Ignoring chronic pain can cause it to worsen or develop into serious medical conditions. If you have chronic pain, receiving treatment from a specialist is the best way to heal it.

What is sleep anxiety?

Sleep anxiety is a form of anxiety caused by stress over not getting enough sleep, but in turn, you sit up for hours and don’t sleep. If you have sleep anxiety, you might feel restless in bed and struggle falling and staying asleep.


Poor sleep causes fatigue and cognitive issues during the day and can lead to serious health conditions down the line. If you’re struggling to sleep due to your painsomnia, you don’t have to suffer in silence. Above all, speak to a medical professional for treatment options, but the habitual changes in your daily life can lead to better sleep.

About the author

Stacy Liman is a journalism graduate student and a freelance writer with a focus on mindfulness and content marketing. Stacy enjoys discovering new mattresses and connecting people with their perfect bed, but she more so enjoys understanding and writing about the science of sleep to help people get deeper, healthier rest.

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