The Connection Between Poor Sleep and Chronic Pain Explained

We all know how frustrating a bad night’s sleep can be. But did you know that poor sleep can also worsen chronic facial pain, including TMJ disorders, myofascial pain, and headaches?

Struggling with sleep deprivation can intensify chronic pain, highlighting the essential link between restful sleep and pain management.

Research shows that the relationship between sleep and pain is bidirectional. Poor sleep can increase pain sensitivity, and chronic pain can further disrupt sleep, creating a vicious cycle.

At Advanced TMJ Maxillofacial Pain & Sleep Center, we often see this pattern in patients suffering from jaw, neck, and facial pain. Let’s take a deeper look at how sleep quality affects your pain, and what you can do about it.

How Sleep Affects Pain Processing

During healthy sleep—especially deep (slow-wave) and REM stages—the brain regulates inflammation, repairs tissues, and modulates pain pathways. When sleep is interrupted or insufficient:

• Pain thresholds drop, meaning your body becomes more sensitive to painful stimuli.

• Inflammatory markers rise, including cytokines like IL-6 and TNF-α, which contribute to muscle and joint pain.

• The body’s ability to self-regulate pain signals (via endogenous opioids and descending inhibition) is impaired.

Studies have shown that even one night of poor sleep can significantly increase pain perception, especially in individuals already prone to chronic pain.​

Conditions Impacted by Poor Sleep

1. Temporomandibular Disorders (TMD)

   Sleep disturbances are common in patients with TMD. Clenching and grinding during sleep (sleep bruxism) can aggravate joint and muscle pain. In return, jaw pain may impair sleep by causing microarousals or frequent awakenings.

   
   

2. Myofascial Pain

   Myofascial pain—tight, tender trigger points in jaw, neck, and facial muscles—is strongly linked with non-restorative sleep. Poor sleep prevents full muscle recovery and worsens central sensitization.

   
   

3. Headaches and Migraines

   Sleep deprivation is a known trigger for both migraines and tension-type headaches. Many patients with chronic headaches report poor sleep quality, insomnia, or delayed sleep onset.

   
   

4. Neuropathic Facial Pain

   Emerging studies suggest that neuropathic pain, such as atypical facial pain or post-traumatic trigeminal neuropathy, may worsen with disrupted sleep due to altered pain modulation in the central nervous system.

   
   

5. Sleep Apnea and Facial Pain

   Obstructive Sleep Apnea (OSA)—a condition where breathing repeatedly stops during sleep—has also been linked with chronic orofacial pain. Patients with OSA often present with:

   1. Morning jaw or facial tension

   2. Daytime fatigue and low pain tolerance

   3. Co-existing TMD or bruxism

      
      

Treating sleep apnea (e.g., with a mandibular advancement device or CPAP) can significantly reduce chronic facial and headache pain in some patients.​

Breaking the Pain–Sleep Cycle

Managing chronic facial pain often requires addressing sleep as a core component of treatment. At our Seattle-based Advanced TMJ Maxillofacial Pain & Sleep center, we integrate:

• Sleep screenings and referrals for sleep studies when needed

• Oral appliance therapy for sleep-disordered breathing

• Trigger point therapy and pain-relieving modalities to reduce nighttime discomfort

• Sleep hygiene education, including calming routines and circadian rhythm support

When to Seek Help when Poor Sleep causes Chronic Pain

If you're struggling with facial pain and poor sleep, you’re not alone, and there is help. A specialist trained in both orofacial pain and dental sleep medicine can evaluate the full picture and guide you toward effective, non-invasive solutions.

References

1. Smith MT et al. Sleep. 2007;30(9):1155–1162. “The role of sleep in pain modulation.”

2. Bevilaqua-Grossi D et al. J Oral Rehabil. 2018;45(2):134–144.

3. Dubé CE et al. Clin J Pain. 2020;36(1):6–13. “Impact of sleep quality on pain-related outcomes in patients with myofascial pain.”

4. Slade GD et al. J Pain. 2013;14(12 Suppl):T116–T124.