A new poll by the National Sleep Foundation (NSF) finds that pain is a key factor in the gap between the amount of sleep Americans say they need and the amount they’re getting—an average 42 minute sleep debt for those with chronic pain and 14 minutes for those who’ve suffered from acute pain in the past week.

By contrast, there’s no overall sleep debt for those without pain—but significant numbers even in this group do have sleep problems. About one in three of those with no pain don’t always or often get a good night’s sleep or the sleep they need to feel their best, or have had trouble falling or staying asleep in the past week. Those problems rise even higher among individuals who do have chronic or acute pain.

The 2015 Sleep in America Poll finds that pain joins two related concerns—stress and poor health—as key correlates of shorter sleep durations and worse sleep quality. But there are paths to resolving the problem: The sleep gap narrows sharply among those who make sleep a priority.

“Taking control of your sleep by being motivated, setting a routine bedtime, and creating a supportive sleep environment are relevant even for those with pain,” says David Cloud, NSF CEO, in a release. “Sleep is a key marker of health, and good sleep habits are critical for improving the quality of life of those living with chronic or acute pain.”

Pain Prevalent, Sleep Suffers

The national, random-sample survey establishes the broad impacts of pain-related sleep loss on millions of Americans. The problem is a notable one given the number of Americans who suffer from pain. The study finds that 21% of Americans experience chronic pain and 36% have had acute pain in the past week. Those combine to a majority of the nation’s adult population, 57%, leaving 43% who report being pain free.

Beyond sleep debt, self-reported sleep quality and stress levels underscore the effects of pain on sleep; 65% of those with no pain reported good or very good sleep quality, while only 46% of those with acute pain and 36% of those with chronic pain did the same. Additionally, 23% of those with chronic pain reported higher stress levels, compared with 7% of those without pain.

Those with acute or chronic pain are more likely to have sleep problems impact their daily lives. Among people who have had sleep difficulties in the past week, more than four in 10 of those with chronic pain say those difficulties interfered with their work. That drops to 17% of those without pain. People with pain are also far more apt than others to report that lack of sleep interferes with their mood, activities, relationships, and enjoyment of life overall.

People with pain also feel less control over their sleep, worry more about lack of sleep affecting their health, and exhibit greater sleep sensitivity. They’re more likely than others to say environmental factors make it more difficult for them to get a good night’s sleep. These factors include noise, light, temperature, and their mattresses alike, suggesting that taking greater care of the bedroom environment may be particularly helpful to pain sufferers.

While both chronic and acute pain relate to lost sleep, the survey indicates that chronic pain is an especially powerful problem. Indeed, nearly one in four people with chronic pain, 23%, say they’ve been diagnosed with a sleep disorder by a doctor, compared with just 6% of all others.

“Clinicians and pain sufferers know that pain and sleep problems present together and aggravate each other. This poll confirms the relationship between pain and sleep. Fortunately, it also shows that simple steps to improving sleep can be beneficial,” says Timothy Roehrs, PhD, of Henry Ford Hospital.

Sleep an Overall Health Indicator

Americans who say they have very good or excellent health and quality of life report sleeping 18 to 23 minutes longer on average in the past week than those who rate their health and quality of life as just good, fair, or poor. Indeed, reported sleep duration and quality decline linearly with each health rating, showing that perceptions of one’s sleep and health are deeply related.

“Sleep quality and duration should be considered a vital sign, as they are strong indicators of overall health and quality of life,” says Kristen Knutson, PhD, National Sleep Foundation Sleep in America Poll Scholar. “Extremely long or short sleep durations are associated with more specific conditions, but for many people who are close to getting the recommended seven to nine hours of sleep, getting just 15 to 30 minutes more sleep a night could make a difference in how they feel.”

Prioritizing Sleep Linked to Better Sleep

Americans who said they were very or extremely motivated to get enough sleep reported sleeping 36 more minutes per night across the week compared with others (7.3 vs 6.7 hours). Even among those with pain, a higher motivation to get sleep was associated with longer sleep durations and better sleep quality.

“Understanding the importance of sleep and taking a proactive approach to bed times can help everyone improve their sleep, even people with pain,” Knutson says. “Taking control of your sleep is an important step in taking control of your health.”

Poll Methodology and Acknowledgments

The 2015 Sleep in America Poll was a probability-based online survey of 1,029 non-institutionalized adults aged 18 years or older residing in the United States. The GfK Group (formerly Knowledge Networks) conducted the 2015 Sleep in America Survey on behalf of Mokrzycki Survey Research Services; field work conducted December 5-12, 2014. Sampling error for estimates from full sample: +/-3.3 percentage points, including adjustment for design effects.

Full background, methodology, and purpose can be found at sleepfoundation.org.

The National Sleep Foundation is indebted to Mike Mokrzycki for his important poll contributions. Mokrzycki passed suddenly on December 19, 2014. He was esteemed in the polling world; he was a journalist, survey researcher, and founding director of the AP Polling unit. Our sincerest condolences to his family. He will be dearly missed.

2015 Sleep in America Poll Task Force

Tim Roehrs, PhD (Chair)
Henry Ford Hospital

Kristen Knutson, PhD (Poll Scholar)
University of Chicago

Daniel Clauw, MD
University of Michigan

D. Sunshine Hillygus, PhD
Duke University

Michael T. Smith, PhD
Johns Hopkins University School of Medicine

Lynn Webster, MD
PRA Health Sciences