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Why sleep matters in chronic pain: evidence across the lifespan

Eoin Maurice Kelleher1, Amanda Wall2, Ben Seymour2

  • 1Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.

Ebiomedicine
|February 18, 2026
PubMed

Insights

Poor sleep can predict chronic pain development and persistence across the lifespan. Addressing sleep issues may offer opportunities for pain prevention and management.

Area of Science:

  • Neuroscience
  • Pain Medicine
  • Sleep Science

Background:

  • Sleep problems and chronic pain frequently coexist.
  • A bidirectional relationship exists where pain disrupts sleep and poor sleep exacerbates pain.
  • Evidence suggests sleep disturbances may precede and contribute to pain persistence.

Purpose of the Study:

  • To explore the evolving sleep-pain relationship across different life stages.
  • To identify shared mechanisms underlying the sleep-pain interplay.
  • To highlight the potential for sleep interventions in pain management.

Main Methods:

  • Narrative review of existing literature.
  • Analysis of the sleep-pain relationship across childhood, adolescence, adulthood, and older age.
  • Exploration of neurodevelopmental, lifestyle, psychological, and comorbidity factors.

Main Results:

  • In childhood/adolescence, poor sleep may predict pain emergence via neurodevelopmental pathways.
  • In adulthood, sleep interacts with stressors to influence pain risk.
  • In older adults, chronic pain and comorbidities worsen sleep, creating a cycle.
  • Shared mechanisms include HPA axis dysregulation, neuroinflammation, and impaired glymphatic clearance.

Conclusions:

  • Early sleep disturbance is a modifiable risk factor for later pain.
  • Improving sleep can be a strategy for preventing pain onset and managing established chronic pain.
  • Understanding the lifespan trajectory of the sleep-pain relationship is crucial for targeted interventions.

Keywords:
Chronic painLifespanNeuroinflammationNociplastic painSleep disturbance

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