Is Sleep the Key to Unlock Pain?

Written By Heidi Mitrushi

A friend of mine asked me my thoughts on undergoing a total joint replacement. He had already had multiple surgeries for this injury. I asked why? What is most affected? He answered, I can’t sleep. The answer in his mind was fix the pain to fix the sleep, but what if fixing our sleep is the key to fix our pain?

woman adjusting weight plates on a barbell in an industrial gym

How much do you think sleep affects your muscle recovery and performance? How much do you think sleep is influencing your pain and rehabilitation from injury? How much do you think sleep impacts your life? If I had to choose one thing that could make the most impact on your recovery, pain and life it’s good quality sleep. Sleep is critical for maintaining healthy muscles and joints and to prevent or heal existing injuries. Why is sleep such an important part of recovery? One reason is, it puts you in anabolic state where growth hormone is released, and tissues are rebuilt.

woman in bed, hugging knees in pain

What about sleep and pain? Sleep is intimately tied to pain, one of the most debilitating symptoms that can coincide with injury. Studies have shown poor sleep quality to be linked with back pain. In one study as back pain improved sleep got better, AND the reverse, if sleep improved back pain got better (Kovacs 2018). 

You might guess that pain causes poor sleep, but poor sleep is also a predictor of who will develop pain. In a study by Simpson 2018, healthy individuals were required to cut their sleep to 4 hours for 4 days followed by 8 hrs for 2 days and with the control group getting 8 hours. After experiencing poor sleep for 1 week they had more spontaneous pain and a lower pain threshold.  Results suggest that exposure to chronic insufficient sleep may increase vulnerability to chronic pain by altering the processing of pain. This included both reduced habituation and increased sensitization. Another study published in the journal Arthritis & Rheumatism found a strong dose-dependent association between sleep problems and risk of developing Fibromyalgia (a chronic debilitating pain condition) over the next 10 years (Mork 2012). Thus, helping sleep disruption can possibly prevent chronic pain. 

illustration of a head and shoulders in black, with the skull opened and the red brain exposed

How does sleep affect pain? Although the exact mechanisms are unknown, one strong theory is that it’s linked to our brain and nervous system. Sleep is necessary for survival just like food and water. When we lack sleep our brain and whole nervous system goes on high alert as if we were under attack. Our sympathetic (fight of flight) nervous system takes over. When we are in a chronic sympathetic state, all of our senses become heightened, including our reaction to heat and pressure and how we perceive pain. Essentially, a smaller amount of stimulus is needed to provoke a large response. The reverse is also true, getting good quality sleep activates our parasympathetic (rest and digest) nervous system and will bring our nervous system back into balance and return pain thresholds back to normal. 

We don’t know all the reasons behind the importance of sleep and the consequences of poor sleep. I think we can safely say that it’s a critical part of recovery from exercise, injury, and pain. What’s most interesting to me is that current research is finding not only that pain causes poor sleep, but sleep disturbance may actually predict pain more strongly. Helping sleep disruption can prevent and treat chronic pain. You want to know why you’re not progressing with your performance or why your nervous system isn’t processing pain well, the answer probably involves poor sleep quality. If you’re with me that sleep is key to maintaining a healthy, pain-free body you will want to download my Eagle Sleep Guide.  


Related podcast links for more info:

Huberman Lab Podcast: Master Your Sleep & Be More Alert When Awake, Episode 2

Huberman Lab Podcast: Dr. Matthew Walker: The Science & Practice of Perfecting Your Sleep, Episode 31

Breathing Essentials That Will Change Your Life –Dave Asprey Podcast with James Nestor, Episode 751

How to Sleep Smarter & Improve the Sleep Habits in your Relationships – Shawn Stevenson Podcast, Episode 637


Heidi Mitrushi