Managing sleep

With Professor Nicole Tang and Dr Thomas Bilterys

Nicole and Thomas are researchers at the University of Warwick’s Sleep and Pain Laboratory.

This information was last updated in June 2025. It is due for a review in June 2028.

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Living with pain and struggling to sleep can feel exhausting and frustrating. Many people think that pain is the only reason why they can’t sleep – but that’s not the whole story. The good news is that even with pain it is possible to get a good night’s sleep. Understanding how sleep works and what other factors might be affecting it can make a big difference. 

Your sleep problems may have started because of pain, but if you’ve been struggling for a while — more than three months, for example — pain is probably not the only reason. Over time, the way you think about sleep, how you feel emotionally and the ways you try to cope can all begin to play a role.

Let’s take a look at the factors beyond pain that may be disrupting your sleep and the ways they might be addressed. Some medicines for pain and mood can also interfere with sleep – speak to your GP about whether making changes to these could help as well. 

Beliefs about pain and sleep

Certain beliefs about sleep can be unhelpful. Let’s look at some common examples and consider how you might combat them.

‘It is essential for me to get eight hours of sleep per night in order to feel refreshed’ 

Different people have different sleep needs at different stages of life. Typical adult sleep durations can be anywhere between five and ten hours a night. The recommended range of seven–nine hours is not necessarily the amount of sleep you need. It is only a rule of thumb. Longer sleep duration is not always better – research shows that sleeping too much can be just as unhealthy as sleeping too little. 

‘When I sleep poorly, I can hardly function the next day’ 

After a poor night’s sleep, it is common to feel tired and less productive. But feeling tired doesn’t mean you can’t get things done or make helpful adjustments. In fact, research shows that people who sleep poorly can perform just as well on tasks as those who sleep well. You may be functioning better than you think – so don’t count yourself out. 

‘Unless I get rid of the pain, I won’t sleep well’ 

Many people believe that insomnia is a mere side effect of pain and that nothing can be done until the pain goes away, or that the insomnia will automatically disappear as soon as the pain is under control. But research shows that this isn’t true – people with chronic pain often sleep better with treatments like cognitive behaviour therapy for insomnia (CBT-I), even if the pain continues. The key message is that you don’t have to wait for the pain to go away to start sleeping better. 

‘When I am in pain I simply can’t get to sleep no matter how hard I try’ 

Pain isn’t always to blame. Sometimes, the problem is trying too hard to fall asleep. The harder you try to get to sleep, the more anxious, frustrated and tense you may feel, making sleep even less likely. Instead of forcing it, let sleep find you. Sleep tends to come naturally when your body and mind are relaxed and ready. 

Eating, drinking and smoking

Certain habits and behaviours can contribute to sleep problems. Here are a few lifestyle factors to think about: 

Caffeinated food and drinks 

If you have had a bad night’s sleep it can be tempting to consume large quantities of caffeine the next day to try and keep you awake. Caffeinated food and drinks include coffee, tea, chocolate, cola and energy drinks. It is important to remember that the stimulating effects of caffeine can last for hours after consumption. Too much caffeine consumed too close to bedtime can make it harder to fall asleep and can make sleep lighter and more restless. 

Smoking 

While smokers may feel relaxed from smoking, nicotine is a stimulant like caffeine. Smoking at night can make it harder to fall and stay asleep. It is also linked to poor sleep quality and disordered breathing, like sleep apnoea and chronic obstructive pulmonary disease (COPD). If you are a smoker and are not prepared to quit, try cutting down on smoking before bedtime.

Heavy meals/too much liquid before bed 

Going to bed hungry is uncomfortable and can cause food cravings. If hunger keeps you up, a light, healthy snack may help. Be mindful that it is generally recommended to eat 2–4 hours before bed to allow for digestion. Eating a heavy meal too close to bedtime keeps your digestive system busy whilst you’re sleeping. Consuming large amounts of liquid before bed is also not advisable as it can mean being woken during the night by the need to use the toilet. 

Physical activity and daily routine

Physical activity and your daily routine are two other areas that you can work on to improve your sleep. The following suggestions may help: 

1. Keep to a regular routine 

Try to stick to consistent times for sleeping, waking, meals and exercise. A steady daily routine helps regulate your body’s clock, making your sleep more predictable. Whilst it is tempting to sleep in after a poor night, doing so can throw off your rhythm and make it harder to sleep well the next night. 

2. Avoid napping 

After a bad night’s sleep, you may feel the need to nap in the day to try to make up for lost sleep. However, regular napping can make it harder to fall asleep at night. It reduces your sleep pressure (your ability to fall asleep) and shifts your internal clock. If you really feel you must nap, keep it short (15–20 minutes, a ‘power nap’) and limit it to the early/middle part of your day. 

3. Only go to bed when you’re sleepy 

When you’re in pain, resting in bed can be very comforting and sometimes necessary. However, spending too much time in bed blurs the boundary between sleep and wake. Over time, your brain may start to associate your bed with being awake instead of sleeping.

4. Stay active 

Being active during the day helps build up sleep pressure, making it easier to fall asleep at night. Even going for a short walk outdoors can help, and the exposure to daylight helps keep your circadian rhythm (which promotes wakefulness and sleepiness) in sync with the natural light/dark cycle. Find advice on managing your activity here.

5. Create a wind-down routine 

Your body takes time to shift gears. Give yourself time to gently transition from wake to sleep, just like how we typically take several minutes to properly wake up from sleep. A calming bedtime routine can help signal to your body that it’s time to relax and transition to sleep. 

Is your bedroom a good environment for sleep?

There are simple ways to make your bedroom more sleep-friendly. 

1. Keep your bedroom temperature comfortable 

Avoid an excessively hot or cold bedroom. Although there is no ideal room temperature for everyone, room temperatures too high (24°C or above) or too low (16°C or below) can interfere with normal sleep. 

2. Minimise noise, light and excitement in the bedroom 

To minimise external noise, close your windows, purchase earplugs or move into a quieter room. If you are disturbed by a partner’s snoring, then you could discuss sometimes sleeping separately to test out if that is a significant reason why your sleep is disturbed. 

Lighting conditions can affect sleep in almost anyone. It is a good idea to have a well-darkened bedroom with curtains or blinds that keep out streetlights or daylight. Try to also minimise the use of phones, tablets or laptops in bed. The screens on these emit blue light, which can send alerting signals to the brain just as you’re getting ready to sleep.

3. Keep your bedroom just for sleeping 

Make your bedroom a sanctuary for sleep! Bedrooms work best when they are associated with calmness. Try keep the room from becoming an office or recreational area, and avoid having entertainment media (television, radio, etc.) or doing any activity that is not sleeping or intimacy (such as snacking, planning, paying bills).