Frequent chronic pain was associated with higher prevalence of short sleep duration, insomnia symptoms, and nonrestorative sleep among US adults, with associations varying in complex ways across age, sex, and race/ethnicity subgroups.
Frequent chronic pain (FCP) was reported by 24% of the overall adult sample, with disproportionately higher prevalence among older adults and women.
FCP was associated with a higher prevalence of short sleep duration, with stronger associations among younger adults compared to older adults.
FCP was associated with a higher prevalence of insomnia symptoms, with stronger associations among men and Hispanic/Latine and Black adults compared to White adults.
FCP was associated with a higher prevalence of nonrestorative sleep (NRS), with stronger associations among older adults and men.
The association between FCP and insomnia symptoms was stronger among racial/ethnic minority groups than among White adults, suggesting differential impact across race and ethnicity.
The directionality of the FCP-sleep relationship is described as potentially bidirectional, with pain impairing sleep and poor sleep increasing pain sensitivity.
This research suggests that adults in the United States who experience frequent chronic pain — defined as musculoskeletal pain occurring most days or every day — are substantially more likely to also have sleep problems, including sleeping fewer than 7 hours a night, having difficulty falling or staying asleep, and waking up feeling unrested. Using a large, nationally representative survey of over 90,000 adults conducted between 2013 and 2018, researchers found that about one in four adults reported frequent chronic pain, with the condition being especially common among people aged 50 and older and among women. Importantly, this research suggests that the relationship between chronic pain and sleep problems is not the same for everyone. Younger adults showed a stronger link between chronic pain and short sleep, while older adults showed a stronger link between chronic pain and waking up feeling unrested. Men with frequent chronic pain were more likely than women with frequent chronic pain to report both insomnia symptoms and nonrestorative sleep. Additionally, Hispanic/Latine and Black adults with frequent chronic pain had a stronger association with insomnia symptoms compared to White adults, highlighting potential disparities in how chronic pain affects sleep health across different communities. This research matters because it demonstrates that the pain-sleep connection is complex and varies meaningfully by age, sex, and race/ethnicity. A one-size-fits-all approach may not be sufficient for addressing sleep problems in people with chronic pain. The authors call for targeted intervention studies that account for these sociodemographic differences, which could eventually help healthcare providers better tailor treatments for individuals who experience both chronic pain and sleep difficulties.
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Upload Your LabsP. Zendels, S. Gaston, M. Vitiello, C. Payne, W. Jackson, Sara Nowakowski, et al.. (2026). Frequent chronic pain in relation to sleep disturbances: A nationally representative study of adults in the United States.. Sleep Medicine. https://doi.org/10.1016/j.sleep.2026.109291