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Chronic pain can interfere with sleep in many ways, from taking longer to fall asleep due to discomfort, to waking during the night when shifting positions triggers pain, to lying awake with racing thoughts that make it challenging to fall back asleep. It could also result in waking too early and being unable to get back to sleep due to pain. These patterns can leave you feeling fatigued.  When you are tired, pain becomes harder to manage, and your body has less opportunity to heal and recover.

What many people don't realize is that this relationship works both ways. Research shows poor sleep can increase pain sensitivity, creating a cycle where pain disrupts sleep and poor or insufficient sleep makes pain worse. When restorative sleep is cut short, night after night, it becomes poor sleep; the body produces less of the hormones needed for tissue repair and for regulating inflammation. Addressing both sleep and pain together is essential to breaking this cycle.

To cope with your insomnia, try doing the following:

• Establish a consistent bedtime-wake time – Go to bed and wake up at the same time every day, even on weekends. A regular schedule supports your body's internal clock, which also helps regulate pain sensitivity.
• Assess your sleep environment for comfort – Use a supportive mattress and pillows suited to your body and pain condition. Placing a pillow between your knees or using a body pillow for support can help manage pain.
• Manage your room temperature – Your body temperature naturally decreases as part of the sleep process, so a slightly cooler room can promote a faster onset and deeper sleep.
• Make time for movement– Regular physical activity can improve sleep quality. For those with chronic pain, gentle movement such as Tai Chi, stretching or walking can reduce pain symptoms and support better sleep.
• Develop a wind-down routine – At least an hour before bed, limit exposure to blue light from screens. A warm bath, reading or a mind-and-body practice such as deep breathing or a body scan can ease the transition into sleep.

Mind-body practice is a natural extension of these habits and deserves special attention for those managing chronic pain. Tai Chi has been shown to improve sleep quality, reduce nighttime waking and decrease pain intensity. Mindfulness-based practices work in a complementary way.  Rather than lying awake, fighting discomfort, mindfulness teaches you to observe pain with less reactivity, quieting the mental and physical tension that disrupts sleep. Helpful techniques include:

• Body scan meditation – A slow, guided attention through each part of the body, consciously releasing tension as you go. Practiced in bed, it can ease sleep onset even when pain is present.
• Mindful breathing – Slow, diaphragmatic breathing activates the body's natural relaxation response, calming both pain perception and racing thoughts.

The American Academy of Sleep Medicine supports cognitive and behavioral approaches, including mindfulness, as a first-line treatment for chronic insomnia. Research published in JAMA Internal Medicine found that mindfulness meditation significantly improved sleep quality in older adults. Even 10–15 minutes before bed can make a meaningful difference. Michigan State University Extension offers evidence-based programs incorporating both Tai Chi and mindfulness to help improve sleep and manage chronic pain. For more information on these programs, complete an online self-referral form.

Finding support through Michigan State University Extension

Although sleeping with chronic pain can be challenging, incorporating some of these tips into your daily routine can help you get a better night's rest. Michigan State University Extension offers several programs to support you. SLEEP (Sleep Education for Everyone Program) is a six-week program that offers evidence-based guidelines to improve sleep hygiene and quality. Tai Chi for Better SLEEP and Mindfulness for Better SLEEP each offer accessible approaches to improving sleep through movement and awareness practices. Michigan State University Extension also offers the evidence-based Chronic Pain PATH (Personal Action Toward Health) series, a six-week self-management workshop designed to help people take an active role in managing chronic pain. Better sleep starts with small steps, and Michigan State University Extension has programs to support you along the way.