How Sleep Loss May Lead To Heightened Pain Sensitivity

Sleep loss can heighten pain sensitivity, making headaches, muscle soreness and chronic pain feel worse. In mice, chronic sleep disruption reduced N-arachidonoyl dopamine (NADA) and cannabinoid receptor activity in a pain-processing thalamic circuit; restoring NADA reduced hyperalgesia. Human studies confirm that poor sleep increases pain sensitivity, but this specific mechanism and treatment remain unproven in people.  

How Sleep Loss May Lead To Heightened Pain Sensitivity
Medically reviewed

Dr. Chrysoula I. Liakou MD, PhD Google Scholar LinkedIn

Internal Medicine Specialist
Cancer Immunology Researcher

What Research Shows About Sleep Deprivation, Brain Signalling and Pain Sensitivity

  • Insomnia symptoms are experienced by approximately 66% of adults at some point in their lives.

  • It's common for people who don't get sufficient sleep to suffer from physical discomfort, such as headaches, migraines, lower back pain, and chronic pain.

  • Insufficient sleep can lead to decreased levels of a particular neurotransmitter, which can cause the body to become more sensitive to pain, according to researchers from Massachusetts General Hospital.

It is estimated that a large portion of adults around the world suffer from sleeplessness, with approximately 50 to 70 million people in the United States alone. These individuals have either sleep apnea or other chronic sleep-related issues.


Studies have shown a correlation between sleeplessness and a variety of severe conditions, including heart disease, road accidents, and diabetes, all of which are among the top 15 causes of death in the United States.


In addition, people who don't get adequate rest often suffer from headaches and migraines, muscle tension, soreness in the lower back, and persistent pain that doesn't go away.



How Sleep Loss Promotes Pain


Although both everyday experience and scientific studies suggest that sleep deprivation and pain are closely related, how lack of sleep increases pain is not well understood.


In this study, researchers employed a mouse model to investigate the connection between insufficient sleep and increased sensitivity to pain.


Scientists discovered that when people do not get sufficient sleep, the levels of NADA in the TRN region of the brain are decreased, which causes people to become more sensitive to pain, a condition known medically as hyperalgesia.


TRN plays a role in regulating the exchange of information between the thalamus and the cerebral cortex, which are both essential to the sensation of pain.


Insufficient sleep leads to decreased neurotransmitters in the brainstem, which can cause the brainstem to malfunction. This, in turn, increases pain sensitivity due to its connections with the thalamus.



Chronic Pain: Cause Or Consequence Of Sleep Issues?


Pain that persists for an extended period, usually over three to six months, is classified as chronic pain.


This type of pain is often more challenging to manage than short-term pain and can have a significant impact on a person's quality of life.


Common types of chronic pain include:

  • Diabetic Neuropathy

  • Pain in scar tissue

  • Headaches and/or Migraine

  • Cancer-associated pain

  • Overall muscle pain, such as fibromyalgia

  • Neck pain

  • Spinal cord injuries

  • Back pain

  • Arthritis


Insufficient sleep has been shown to cause and exacerbate chronic pain in past studies.


Not getting enough sleep can aggravate the chronic pain, and the anxiety, depression, and preoccupation with the pain can cause the patient to become chronically insomnia. This creates a continuous cycle of pain, lack of sleep, more pain, and so on.



Treating Pain Induced By Sleep Loss


Researchers think that they will be able to use these discoveries in the future to help prevent or reduce the chronic pain often associated with sleep deprivation.


The study provides a structure to investigate the interconnectedness of chronic pain and inadequate sleep. Furthermore, detecting N-arachidonoyl dopamineTrusted Source (NADA) provides possibilities for testing the effectiveness of this molecule or similar ones in relieving pain caused by sleep deprivation.


These results emphasize that chronic pain is a complex issue and should be addressed through an integrated approach comprised of multiple disciplines.


In the scientific approach, the researchers aim to break down how neurons in the TRN work together to shape the pain response caused by sleep deprivation. For the translational investigations, they will assess whether NADA or any other compounds can alleviate pain caused by a lack of sleep.



Better Pain Treatments That Aren’t Narcotics


A recent study has shed light on the importance of finding non-addictive alternatives to pain management rather than relying solely on habit-forming medications like narcotics.


The study examined the impact of sleep deprivation on pain and focused on a naturally occurring substance in the body called NADA (Naturally Occurring Anti-Inflammatory Substance).


The findings revealed that sleep deprivation led to reduced levels of NADA, which in turn appeared to increase the perception of pain. This underscores the vital role sleep plays in aiding the body's natural healing and regenerative processes.


Moreover, the study hinted at broader implications, as NADA is implicated in various chronic diseases such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and epilepsy. Research in populations with these conditions could potentially yield improved treatment options.


Researchers hope that pharmaceutical companies will consider this research and explore the development of therapies to address the deficiency of NADA in the central nervous system.


Such treatments could modulate the central nervous system, particularly during nighttime, and potentially alleviate hyperalgesia in chronic pain patients. Expanding this research to human trials and developing corresponding pharmaceutical solutions holds promise for enhancing sleep quality and managing pain effectively without exacerbation.


Tips For Better Sleep


Here are some recommended tips for improving sleep hygiene and getting a better night's sleep:

  • Establish and stick to a consistent sleep schedule.

  • Reserve the bed for sleep and intimate activities only.

  • Maintain a comfortable bedroom environment by keeping it cool, quiet, and dimly lit. Invest in supportive bedding like pillows, sheets, and blankets.

  • Avoid engaging in exciting or violent content before bedtime.

  • Consider taking a relaxing, warm shower before going to sleep.

  • Enjoy a calming beverage like chamomile tea or warm milk.

  • Steer clear of stressful events, discussions, or argumentative phone calls before bedtime.

  • If you have prescribed nighttime medications, take them as directed.

  • Limit the consumption of caffeinated products, especially in the afternoon.

  • Engage in regular exercise.

  • Follow a healthy diet.

  • Practice meditation and relaxation techniques.

Consult with your healthcare provider if you have medical conditions that impact your sleep, such as pain, anxiety, swelling, shortness of breath, or heart-related issues.


Mobi Doctor offers convenient access to healthcare professionals who can provide expert advice and consultations. Whether you have health concerns or need medical guidance, Mobi Doctor is here to assist you with experienced healthcare professionals ready to help.



Sleep Deprivation, Pain Sensitivity and Chronic Pain FAQs

Pain can feel worse after poor sleep because sleep loss disrupts the nervous system’s normal pain-inhibiting processes and increases sensitivity to repeated painful signals. Experimental sleep deprivation has increased pressure and cold-pain sensitivity while weakening conditioned pain modulation. Fatigue, low mood and heightened attention to discomfort may further intensify the experience.

Researchers found that five days of chronic sleep disruption in mice reduced N-arachidonoyl dopamine, or NADA, and cannabinoid receptor 1 activity in the thalamic reticular nucleus. The animals became more sensitive to mechanical and heat stimuli, while administering NADA directly into that brain region reduced hyperalgesia. This identifies a possible biological pathway rather than an available treatment.

No, the NADA experiments were performed in mice. They do not establish that the same mechanism operates identically in people or that NADA-based treatment would be safe or effective. Separate human studies show that sleep deprivation increases pain sensitivity, but clinical trials are required before this laboratory finding can guide treatment.

Even one night of severe sleep loss can temporarily increase pain sensitivity. In a study of 24 healthy adults, 24 hours without sleep lowered pressure-pain tolerance, increased cold-pain sensitivity and impaired the body’s normal pain-inhibiting response. A typical mildly disturbed night may have a smaller effect than complete sleep deprivation.

Both can occur, but poor sleep may be the stronger short-term driver for some people. In a diary study of 119 patients with chronic pain and insomnia, sleep quality consistently predicted next-day pain, whereas presleep pain did not reliably predict that night’s sleep. Over time, discomfort, worry and repeated awakenings can still reinforce the sleep–pain cycle.

Poor sleep is commonly linked with headaches, migraine, back and neck pain, arthritis, fibromyalgia, neuropathic pain and general muscle soreness. Sleep loss does not necessarily cause the underlying condition, but it can lower pain tolerance and amplify existing symptoms. New, persistent or unexplained pain should still be evaluated independently.

Better sleep may reduce the burden of chronic pain for some people, but it does not reliably eliminate pain. In a randomised trial, adding cognitive behavioural therapy for insomnia to evidence-based spinal pain management improved insomnia and sleep quality but did not produce a statistically significant additional reduction in average pain intensity. Sleep treatment should complement condition-specific pain care.

Helpful habits include keeping consistent sleep and wake times, reserving the bed for sleep, limiting afternoon caffeine, using a cool, dark and quiet bedroom, exercising regularly and practising relaxation before bedtime. These measures support healthier sleep but do not treat every cause of pain or insomnia. Prescribed night-time medicines should be taken only as directed.

Medical assessment is appropriate when pain or insomnia persists, worsens or repeatedly disrupts daily functioning. Evaluation can identify conditions such as sleep apnoea, medication effects, anxiety or an untreated pain disorder. Sudden chest pain, severe breathing difficulty, confusion or loss of consciousness requires emergency help rather than waiting for sleep or pain to improve.


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