Living with chronic pain is a reality for nearly 50 million adults—and for many, the discomfort doesn’t ease with the setting sun. In fact, nighttime often makes the pain feel worse and more disruptive, particularly when you’re trying to sleep.

Why Does Pain Intensify at Night?

Pain levels can fluctuate over the course of the day, and some research suggests that our body’s internal clock, known as the circadian rhythm, may play a role. Just as it regulates the sleep-wake cycle, it may also influence how intensely pain is felt. When the body slows down at night and distractions fade away, there’s often nothing to shift attention from the pain. This can make symptoms feel more pronounced—even if the actual pain hasn’t increased.

Nighttime pain doesn’t just affect comfort; it can deeply impact sleep. About half of all people who struggle with insomnia also live with chronic pain. Sleep disorders like restless legs syndrome and sleep apnea are also commonly linked to pain, creating a vicious cycle where pain disturbs sleep, and poor sleep makes pain worse by heightening the body’s inflammatory response.

What Can You Do to Sleep Better with Pain?

The good news is that you don’t have to simply endure sleepless nights. A combination of practical techniques and environmental changes can help reduce nighttime discomfort and improve sleep quality.

Build a Consistent Wind-Down Routine

Creating a buffer between the stress of the day and bedtime can help calm the nervous system. Set aside at least 20 minutes to engage in calming activities. This might include:

• Taking a warm or cool shower
• Doing gentle stretches or light yoga
• Practicing deep breathing or meditation

These actions help lower stress hormone levels and promote a sense of relaxation that makes sleep more accessible—even when pain is present.

Optimize Your Sleep Environment

Your bedroom should support sleep, not disrupt it. Start by making the space cool and dark—ideally between 65° and 68°F. Blackout curtains, sleep-friendly fabrics, and soft lighting can all help. A comfortable mattress and supportive pillows are essential, especially if your pain is localized. Consider adding a white noise machine or calming soundscapes like rainfall to block out background noise.

Adjust Your Sleeping Position

Sometimes simply changing how you sleep can ease pressure on painful areas.

• Neck pain: Use a low or flat pillow to maintain a neutral neck position, avoid sleeping on your stomach
• Lower back pain: Try lying on your back or side with knees bent at about 90 degrees
• Knee pain: A pillow between your knees can reduce joint pressure
• Hip pain: Sleep on your back, or use a pillow between your legs when lying on your side to minimize strain

Shift the Way You Think About Pain

The fear of pain flaring up at night can be enough to prevent sleep. Stress and anxiety around sleep itself can heighten discomfort. Try to reframe your thoughts: remind yourself that sleep is still possible and that you’ve managed before. Positive self-talk may not eliminate pain, but it can reduce the stress response that amplifies it.

If You Wake Up, Ease Back Into Sleep Gently

When pain disrupts your rest, don’t rush to force sleep. Instead, ease into it. Listen to soft music, or read a physical book in low light. Stay away from screens—phones, tablets, and computers emit blue light that interferes with melatonin, the hormone that helps regulate sleep.

Also read: What Ayurveda and Traditional Medicine Teach Us

In Short

Chronic pain and sleep disruption often go hand in hand—but that doesn’t mean restful nights are out of reach. By building healthier routines, adjusting your sleeping environment and posture, and managing your mental approach, you can take meaningful steps toward getting the restorative sleep your body needs to heal and cope.