Assessing and Managing Sleep Disturbance in Patients with Chronic Pain

Anesthesiol Clin. 2016 Jun;34(2):379-93. doi: 10.1016/j.anclin.2016.01.007.


Chronic pain is associated with symptoms that may impair a patient's quality of life, including emotional distress, fatigue, and sleep disturbance. There is a high prevalence of concomitant pain and sleep disturbance. Studies support the hypothesis that sleep and pain have a bidirectional and reciprocal relationship. Clinicians who manage patients with chronic pain often focus on interventions that relieve pain, and assessing and treating sleep disturbance are secondary or not addressed. This article reviews the literature on pain and co-occurring sleep disturbance, describes the assessment of sleep disturbance, and outlines nonpharmacologic and pharmacologic treatment strategies to improve sleep in patients with chronic pain.

Keywords: Chronic pain; Cognitive behavior therapy; Insomnia; Pharmacotherapy; Sleep-disordered breathing.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Chronic Pain / complications*
  • Cognitive Behavioral Therapy
  • GABA-A Receptor Agonists / therapeutic use
  • Humans
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / therapy


  • Analgesics, Opioid
  • Antidepressive Agents
  • Antipsychotic Agents
  • GABA-A Receptor Agonists