Breaking the Cycle: Chronic Pain, Anxiety, and Poor Quality of Sleep

According to a study conducted by the Centers for Disease Control in 2016 (Pain News Network, 2018), it is estimated that 50 million Americans suffer from chronic pain.  It is common for people who endure such extreme pain to also report anxiety and disrupted sleep, which often leads to frustration and difficulty functioning during the day.  Many take narcotic pain medications for an extended time, not realizing that with extended narcotic use, the body actually becomes more sensitive to pain, creating a physiological and psychological need for more pain medication.  Progressing through sleep stages at night is vital for physical and emotional health.  Sleep plays a major role in dealing with stressors that can lead to anxiety.  For example, REM (Rapid Eye Movement) sleep provides the ability to handle life’s stressors and when people are deficient of it, they also have more difficulty dealing with life’s frustrations. Getting enough REM sleep at night (often disrupted by pain) will provide more emotional reserves to function during the day. 

What about anxiety? Anxiety can cause disruption to sleep patterns, but added to a pre-existing pain condition can really cause havoc on the mind and body. The interaction between anxiety and pain is emotional and physiological.  When a person encounters a stressor (anxiety), a physiological response occurs, (i.e., muscles tighten, breathing, heart and blood pressure rates increase, etc.) which inevitably increases pain.  By counteracting the stress response with a relaxation response, (i.e., diaphragmatic slower breathing, releasing muscle tension, etc.) the brain sends a message to the body that there is no present danger, which decreases pain levels caused by anxious thoughts.  In this way, by decreasing anxiety, pain is automatically lowered. 

Although chronic pain is life-changing and difficult to manage, there are effective ways to lessen the pain levels and allow patients to recover restful sleep at night and participate in activities during the day.  As mental health providers whose patients often complain of pain, anxiety, and poor sleep, we have tools that can interrupt this cycle.  It is imperative for patients to recognize that each element influences the others.  Mindfulness and meditation are useful relaxation techniques to help patients control anxious thoughts that often increase pain.  While paying attention to pain increases pain, intentionally focusing on imagery and breathing distracts the brain from thinking about pain.  Slowing abdominal breathing is also a great way to relax the body and relieve anxiety.  Autogenic Training (thinking about warming and relaxing the body) is a desensitization- relaxation technique designed for pain patients to calm the Central Nervous System.  The main purpose of autogenic training is the achievement of autonomic self-regulation by removing environmental distraction.  Equally important is the relationship with patients;  listening and understanding their pain and the great loss they are experiencing.  Anxiety, pain, and sleep quality are important factors in a cycle that must be interrupted if patients are going to regain their strength and function in life.


Dr. Revis Ann Massey is a licensed Psychologist at our Richardson, TX clinic. Special interests include working with people (and caregivers) of all ages who are coping with relationship problems, chronic illnesses or pain-related issues, women’s health, communication problems, anxiety, and depression.  Revis Ann believes that we all struggle with emotional and mental issues at some time and need help to get back on track.  Our bodies are created with emotional, spiritual, mental, and physical components, equally important.  If one area is out of sorts, the whole body suffers.