If you suffer from nerve pain caused by diabetic neuropathy, physical trauma, sciatica, lupus, arthritis, or other causes, you may find that your pain gets worse at night. While not everyone experiences this, it is quite common for people with nerve pain to report greater pain later at night or whenever they get in bed.
The pain may make it harder for you to get quality sleep, and that may in turn make your pain and overall health and wellbeing even worse. It’s a vicious cycle.
Let’s look first at why your nerve pain may be worse at night, then we’ll look at some ways you may be able to get better rest.
Why Nerve Pain is Worse at Night
Just as chronic pain can have many causes, so too can increased pain at night. Not all causes are fully understood, but here are some possible reasons you may be hurting more at night.
When you lay down, the weight of your body may put pressure on your nerves in ways that it doesn’t when you’re upright. This is particularly common with sciatica and other chronic pain caused by pinched or compressed nerves.
Cooler temperatures help many people sleep better. However, cold can also make arthritis pain worse. Neuropathy may make you more sensitive to cold and more likely to experience it as pain.
Attention and Distraction
You may simply be more aware of your pain at night when there is less to distract you from it. This doesn’t mean the pain isn’t real — it is — only that you may be noticing it more at night than you do when you have other things to occupy your mind.
As your body prepares itself for sleep, your hormone levels, metabolism, and many other biochemical processes adjust. Some of these changes may heighten your pain. Cortisol, for example, has anti-inflammatory effects. However, your cortisol levels drop through the first half of your sleep cycle to let you rest, potentially making pain from rheumatoid arthritis worse.
Medication Timing and Dosage
The medications that control your pain well during the day may be wearing off too soon at night. Or your nighttime biochemistry and symptoms may require a different dosage or medicine.
How to Sleep Better with Chronic Pain
You and your pain management specialist may have to take an experimental approach to sleeping better. What works well for one kind of chronic pain may not work well for another, and your body will respond in its own unique way. Here are some strategies that may help you reduce your nighttime pain and get better sleep.
Try Sleeping in Different Positions
If your chronic pain is caused by pinched or compressed nerves, adjusting your sleep position may relieve some of the pressure. For example, people with sciatica who prefer to sleep on their side often find it helpful to sleep with their affected leg on top. People with hip or knee pain may find relief by sleeping with a pillow between their legs.
Adjust the Temperature
Experiment with different room temperatures when you sleep. It may take some time to find the best temperature for you: cool enough to help you sleep, not cold enough to make your pain worse. Consider keeping a journal of each night’s room temperature, sleep quality, and pain, then see what patterns you notice over time.
Get Appropriate Exercise During the Day
Exercise during the day can help reduce some kinds of chronic pain, and it may help you rest better too. Talk with your pain management doctor about what kinds of exercise are appropriate and safe for you.
Practice Good Sleep Habits
While the day’s stimulations may distract you from your pain, they won’t help you sleep. Develop a sleep routine that helps prepare your body for rest. This might include turning off the TV and other screens 1-2 hours before bedtime, reading a book, or taking a warm bath. Anything that helps you relax and unwind before you head to sleep.
Prepare Your Mind for Rest
The stress of chronic pain can make it even harder to rest. Try meditation or deep breathing exercises to lower your stress and help reduce your perception of pain. They also give you something else to focus on instead of your pain.
Talk With Your Doctor About Your Medications
If the medications you’re taking to manage your pain are wearing off or not working as well at night, tell your doctor and discuss your options. For example, if you have rheumatoid arthritis, your doctor may recommend modified-release corticosteroids to prevent nighttime inflammation.
Good Sleep for Better Health
Whatever you do, don’t suffer sleeplessly in silence. Chronic poor sleep will only make your chronic pain worse, and it robs you of a better quality of life. Less nighttime pain and better sleep will help you feel better all day long.
If you’d like some help managing your pain for better rest and health, you can make an appointment with any United Physician Group Pain Management practice. We offer effective treatments that bring lasting relief. We’ll help you rest well and get your life back.