Infrequently Asked Questions: Why do we feel more pain at night? -we-feel-more-pain-night/

Why do we seem to experience so much heightened pain at odd hours of the day? The morning, night, etc.

I’m not sure that is the case. There are two sides to this: There are reasons why, if you have a toothache or stiff neck, you may experience more pain. But there’s the other side of the pain cycles that counter against that. So you have to look at the [different viewpoints].

So, in the more simple terms, when nothing is distracting you and you’re trying to sleep, things bother you more. So distraction itself is a way to reduce pain. All sorts of distractions — technology, techniques, imagery, things like that. If you’re doing nothing but lying there trying to sleep, then yeah, I think you focus on your pain more. So that’s perhaps one avenue. If you’re fatigued, patients who are fatigued tend to hurt more. And even in the chronic pain setting, if you don’t get adequate sleep, you tend to have exaggerated pain responses. Or if it’s colder at night, sometimes cold can be a trigger.


My pain at night, just at night is off the charts. It increases as the day goes on. And it doesn’t follow my pain medication, which is how my pain doc knows my pain medication doesn’t affect the migraines. Because the migraine pain generally raises as the day progresses, unless in the rare cases a triptan works it will be interrupted (and generally come back). I may start with a 6 or a 7 but I end at an 8 or 9. Typically. I have excessive painsomnia and insomnia. Without pain, I have delayed onset insomnia with frequent wakings. With the pain it is just substantially worse. Without medication for sleep, I get sleep deprivation which causes the migraines to be 24/7 and I get nightly sleep paralysis. And eventually these seizure like experiences that are apparently caused by lack of sleep. So apparently we do in fact need sleep. And pain is bad for that. Even with medication, there are nights I simply do not sleep. End of story. Depends entirely on pain level. My pain medication does help with my FM pain moderately though unless I am in a flare up, so there is that.

Now, distraction is vital. It gets pretty impossible around the 9 range but other than that we all know that it affects how we deal with pain. If we do nothing, we just sit there immersed in pain. Like meditating on the painness of it all. Gee, this pain seems particularly agonizing right now. And, yes, when we are trying to sleep… it is brutal. Thus the word Painsomnia. It is the pain that creates the insomnia. Sometimes I get up and sit up for a bit just because the pain is so intense and I cannot stand just laying there in it. Sometimes I feel like I have been trying to sleep for hours and it has been twenty minutes… that is generally with high levels of pain, it warps my perception of time because it is literally all I am thinking about. So obviously when we can distract ourselves in any way at any time we perceive the pain as a lower level. That is the one good thing about work… a good distraction. This isn’t to say pain doesn’t have side effects because it does. We can distract ourselves, but it distracts us right on back. So it needs to be within manageable levels.

He mentions fatigue making pain hurt more. And the lack of sleep issue heightening pain. Well, this is the chronic pain existence. Why sleep is so vital to get, but we have troubles sleeping, which aggravates our pain and increases our fatigue… and on and on we go. It is a complicated cycle.  It is why we have to have a conversation with our doctors about pain at night and quality of sleep to see if they can help manage out needs better.

For the painsomnia: I have begun the habit of meditating at night before bed. It was tricky in the beginning because it felt like I was marinating in the pain, which really seemed rather counter-productive to be honest. Let’s just close our eyes and focus on how much pain we are in? Hmm. But I was doing a mindful meditation exercise that focuses on breathing. So you focus on the sensation of breath going in and out or the sensation of your stomach rising and falling or the sensation of the air going down to your stomach… whatever works. And in the beginning, you find the location that hurts… everywhere, but I focus on my migraine pain, and you breathe into that pain. Which hurts like the devil for a migraine. Feels like my head is going to erupt and spawn a new world. But then you breathe out and all this pain is released. You do this several times before going into the regular breathing exercise and for some inexplicable reason, it soothes my pain a bit. I think it is the relaxation of it. Like releasing a muscle. You wouldn’t think it would work because of migraine, head, pain… not pleasant when taking a deep breath into it. And for the regular breathing, you don’t deep breath, to avoid the aggravation to the head in fact. It works for me enough that I can lay down prepared for sleep.

Only with an 8 or less pain mind you. And not saying it works for sleep because that is plain ludicrous for me to say that with my insomnia. It just makes it more pleasant to try and sleep. Or to pretend to sleep. Or lay there and daydream. Or contemplate the secrets of the universe. All the things insomniacs do. I do recommend giving it a go.

The app I have been using is called Buddhify

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