By Pat Anson, PNN Editor

Does pain keep you awake at night? A new survey found that a surprising number of Americans are unable to get a full night’s sleep because of “painsomnia.”

Almost 98% of U.S. adults surveyed by the Sleep Foundation say they experience pain at least one night a week. About 85% said pain costs them at least two hours of sleep each night, with the average respondent losing six hours of sleep per week.  

Back pain was the most common reason for painsomnia (56%), followed by neck pain (41%), head pain (32%) and knee pain (29%).

“Pain does not have to be extreme to keep us awake,” says Alex Dimitriu, MD, founder of Menlo Park Psychiatry and Sleep Medicine, and a member of the Sleep Foundation's medical-review board. “Even milder forms of pain can result in varying degrees of insomnia, resulting in trouble falling or staying asleep.”

Adults who live with pain average just 6.7 hours of sleep per night, below the recommended 7 to 9 hours. A recent meta-analysis of 31 studies found that sleep loss increases our perception of pain and creates a vicious cycle. Poor sleep leads to more pain and vice versa.

“When you can’t sleep well due to pain, this leads to more pain,” said Medhat Mikhael, MD, a pain management specialist and medical director of the Spine Health Center at Orange Coast Medical Center in Fountain Valley, CA. “You also become anxious about not sleeping enough, so you don’t sleep. Then you’re fatigued, so you feel a lot more pain.”

When asked to rate their pain on a zero to ten scale, 73% of respondents with chronic pain said their nightly pain was at level 5 or higher. Over half (57%) said they wake up at least three times during the night, and 41% say they wake up earlier than they’d like.  Experts say fitful sleeping is less restorative and heightens pain sensitivity.

“Sleep is as much about quality as it is about quantity,” Dimitriu says. “Falling asleep too late can push circadian rhythms into a delayed sleep-phase cycle. And waking too early can result in an advanced sleep phase cycle, where you get tired too early in the evening.”

What are people doing about their poor sleep? Over half of respondents (56%) who lose sleep to pain have taken sleep aids in the past month. Melatonin was the most popular (49%), followed by Benadryl (diphenhydramine) (23%).

A surprising number said connecting with others in pain support groups helps them sleep. Although only 1 in 5 pain sufferers say they’ve participated in support groups, 91% of those who did say interacting with other painsomniacs helped them learn how to better manage, understand or improve their sleep.

This Sleep Foundation survey was conducted online in June, 2022. Results are from 1,250 participants aged 18 and older who lived in the United States.