Clinical Perspectives on Sleep-Pain Interactions
Med Clin North Am. 2026 Sep;110(5):789-807. doi: 10.1016/j.mcna.2025.12.010. Epub 2026 Feb 12.
ABSTRACT
Sleep disturbances and chronic pain frequently co-occur and interact through complex, bidirectional pathways that span neurobiological, psychological, and behavioral domains. This work synthesizes current evidence on the mechanisms linking sleep and pain, such as neuroinflammation, autonomic imbalance, impaired pain modulation, circadian disruption, and cognitive-affective processes. Longitudinal and microlongitudinal studies consistently demonstrate that poor sleep is a robust predictor of pain onset, escalation, and chronification, while pain also meaningfully disrupts sleep continuity and quality. Practical guidance is provided for integrating behavioral, physical, and pharmacological approaches within coordinated, interprofessional care pathways.
PMID:42498425 | DOI:10.1016/j.mcna.2025.12.010