Sleep and pain frequently overlap, but the measured relationship depends on the population, definition and study design. The figures below cover U.S. adults, a 45-country low- and middle-income sample, chronic-pain populations and experimental or prospective research, with dates and limitations kept explicit.
Key Sleep and Pain Statistics
The most useful headline figures span prevalence, severity, sleep loss and observed risk:
- In 2023, 24.3% of U.S. adults age 18 and older had chronic pain during the prior 3 months.
- In 2023, 8.5% of U.S. adults age 18 and older had high-impact chronic pain.
- In 2021, 51.6 million U.S. adults experienced chronic pain, based on an estimate from the National Health Interview Survey.
- In 2021, 17.1 million U.S. adults experienced high-impact chronic pain.
- In 2022, 36.8% of U.S. adults reported insufficient sleep in the Behavioral Risk Factor Surveillance System.
- In 2022, insufficient sleep ranged from 30.0% in Vermont to 45.9% in Hawaii among U.S. states.
- In 2023, women had chronic pain prevalence of 25.4%, compared with 23.2% for men in the United States.
- In the 45-country World Health Survey sample, 9.1% of adults reported severe pain during the past 30 days.
- Across the same 45-country sample, 7.8% of adults had severe sleep problems.
- In that study, severe pain was associated with 9.35-fold higher odds of severe sleep problems than no pain.
- A meta-analysis of studies through June 2017 found 44% pooled prevalence of diagnosed sleep disorders among adults with chronic pain.
- In those chronic-pain samples, insomnia was the most common diagnosed sleep disorder at 72%.
- Among healthy subjects, a meta-analysis through 2015 found a within-group sleep-deprivation effect of SMD 1.49 on pain perception.
- A review through June 2022 found partial sleep deprivation increased spontaneous pain intensity with effect size 0.30 in healthy people.
- A prospective meta-analysis published through 2024 found baseline sleep problems were associated with short-term chronic musculoskeletal pain at OR 1.64.
- In the HUNT study, three nighttime insomnia symptoms corresponded to RR 3.08 for chronic widespread pain.
Contents
- Key Sleep and Pain Statistics
- U.S. Chronic Pain and Insufficient Sleep Trends
- Sleep and Pain Statistics by Sex, Age, Race and Ethnicity
- Global Pain Severity and Sleep Disturbance Data
- Insomnia, Sleep Disorders and Chronic Pain
- Sleep Loss and Pain Sensitivity Evidence
- Longitudinal Sleep and Pain Risk Statistics
U.S. Chronic Pain and Insufficient Sleep Trends
CDC National Health Interview Survey estimates define chronic pain as pain on most days or every day in the prior 3 months. High-impact chronic pain adds limitation of life or work on most days or every day.
| Measure | Earlier period | Later period | Population and source |
|---|---|---|---|
| Chronic pain | 20.4% in 2019 | 24.3% in 2023 | U.S. adults age 18+; CDC/NCHS |
| High-impact chronic pain | 7.4% in 2019 | 8.5% in 2023 | U.S. adults age 18+; CDC/NCHS |
| Chronic pain | 20.9% in 2021 | — | U.S. adults, age-adjusted; CDC MMWR |
| High-impact chronic pain | 6.9% in 2021 | — | U.S. adults, age-adjusted; CDC MMWR |
The 2021 CDC estimate also counted 51.6 million U.S. adults with chronic pain and 17.1 million with high-impact chronic pain. The population was civilian, noninstitutionalized adults, and the counts were estimated from 2019–2021 NHIS data; the 2019 and 2023 percentage series come from the NHIS household survey and should not be treated as a clinical diagnosis.
CDC BRFSS sleep estimates use self-reported average sleep duration, with insufficient sleep defined as fewer than 7 hours in 24 hours. The core sleep question was not asked in 2015, 2017, 2019 or 2021.
| BRFSS sleep measure | Result | Population and period |
|---|---|---|
| Insufficient sleep | 35.8% | U.S. adults, 2013 |
| Insufficient sleep | 33.3% | U.S. adults, 2020 |
| Insufficient sleep | 36.8% | U.S. adults, 2022 |
| State range | 30.0%–45.9% | U.S. states, 2022: Vermont to Hawaii |
| Colorado | 30.6% | Adults, 2022 |
| Alabama | 41.4% | Adults, 2022 |
Source for the sleep trend, state and subgroup estimates: CDC FastStats: Sleep in Adults. Guam was 50.2% in 2022, while the 30.0%–45.9% range above is for U.S. states.
Sleep and Pain Statistics by Sex, Age, Race and Ethnicity
The U.S. pain estimates show differences by sex and selected racial or ethnic groups, while the sleep estimates provide additional age and subgroup context. These measures come from different CDC surveys and should not be read as a single matched sleep-pain cross-tabulation.
- In 2023, chronic pain affected 25.4% of U.S. women and 23.2% of U.S. men.
- In 2023, high-impact chronic pain affected 9.6% of U.S. women and 7.3% of U.S. men.
- In 2023, chronic pain prevalence was 30.7% among non-Hispanic American Indian or Alaska Native adults.
- In 2023, chronic pain prevalence was 11.8% among non-Hispanic Asian adults.
- In 2023, chronic pain prevalence was 17.1% among Hispanic adults.
The CDC reports these as self-reported NHIS subgroup estimates. Source: Chronic Pain and High-impact Chronic Pain in U.S. Adults, 2023.
| 2022 insufficient-sleep subgroup | Reported result | Definition or note |
|---|---|---|
| Men | About 37% | U.S. adult men; rounded BRFSS page text |
| Ages 45–64 | About 39% | U.S. adults; rounded BRFSS page text |
| Age 65+ | About 28% | U.S. adults; rounded in the CDC table interval |
| Native Hawaiian or Pacific Islander adults | About 49% | Rounded BRFSS page text |
| Black or African American adults | 45.4%–47.4% | 95% confidence interval; displayed table omits point estimate |
| White adults | 32.8%–33.5% | 95% confidence interval |
Source: CDC FastStats: Sleep in Adults. The rounded values and intervals are retained as displayed rather than converted into unsupported point estimates.
Global Pain Severity and Sleep Disturbance Data
A World Health Survey analysis examined 240,820 participants across 45 low- and middle-income countries. It measured self-reported pain during the past 30 days and severe sleep problems using the survey instrument, so these results describe an observational community sample rather than a causal experiment.
| Pain category | Prevalence among adults in 45 LMICs |
|---|---|
| Mild pain | 26.0% |
| Moderate pain | 16.2% |
| Severe pain | 9.1% |
| Extreme pain | 2.2% |
| Severe sleep problems | 7.8% |
Moderate pain was associated with 3.65-fold higher odds of severe sleep problems than no pain. The corresponding adjusted odds ratios were 9.35 for severe pain and 16.84 for extreme pain, compared with no pain.
Source: Pain and severe sleep disturbance in the general population. The associations were adjusted observational estimates and do not establish that pain caused sleep problems.
Insomnia, Sleep Disorders and Chronic Pain
A meta-analysis of 37 studies through June 2017 estimated diagnosed sleep-disorder prevalence among adults living with chronic pain. The samples included varied pain conditions, diagnostic approaches and populations, so the pooled results are not universal prevalence estimates for every person with chronic pain.
- The pooled prevalence of diagnosed sleep disorders among adults with chronic pain was 44%.
- Insomnia was the most common diagnosed sleep disorder in the chronic-pain samples, with pooled prevalence of 72%.
- Restless legs syndrome prevalence among adults with chronic pain was 32%.
- Obstructive sleep apnea prevalence among adults with chronic pain was 32%.
Source: Sleep disturbances and sleep disorders in adults living with chronic pain. The study period ended in June 2017, and diagnostic methods varied across the included studies.
Sleep Loss and Pain Sensitivity Evidence
Experimental studies measure changes in pain perception or thresholds, not the share of a population with pain. A meta-analysis of published studies through 2015 focused on healthy subjects and reported standardized mean differences.
| Experimental comparison | Pooled result | 95% confidence interval |
|---|---|---|
| Between-group sleep deprivation and pain perception | SMD 0.62 | 0.12–1.12 |
| Within-group sleep deprivation and pain perception | SMD 1.49 | 0.82–2.17 |
Source: The effect of sleep deprivation on pain perception in healthy subjects. The clinical relevance of these standardized effects remains uncertain.
A later systematic review covering studies through June 2022 found that total sleep deprivation reduced pain threshold and tolerance with pooled effect sizes of 0.74–0.95 in healthy individuals, although the evidence was rated limited. Partial sleep deprivation increased spontaneous pain intensity with effect size 0.30, with moderate evidence, while sleep fragmentation increased peripheral and central sensitization with effect sizes of 0.42–0.79, with evidence ranging from very limited to moderate.
The review included 31 studies of 699 healthy individuals and 47 people with chronic pain. Its chronic-pain findings remained uncertain, so the healthy-participant results should not be generalized directly to people living with chronic pain.
Source: The differential effects of sleep deprivation on pain perception.
Longitudinal Sleep and Pain Risk Statistics
Prospective research helps show whether baseline sleep problems and later pain or disability are related, but observational odds ratios and relative risks still do not prove causation. A systematic review with meta-analysis of prospective cohorts published through 2024 examined both directions of the relationship.
| Baseline measure and later outcome | Association |
|---|---|
| Sleep problems → short-term chronic musculoskeletal pain | OR 1.64; 95% CI 1.01–2.65 |
| Sleep problems → long-term chronic musculoskeletal pain | OR 1.39 |
| Chronic musculoskeletal pain → short-term sleep problems | OR 1.56 |
| Widespread pain → long-term sleep problems | OR 2.00 |
The review covered adults in 11 study populations. It described the certainty of evidence for sleep-problem categories and some pain categories as very uncertain.
Source: The bidirectional relationship between sleep problems and chronic musculoskeletal pain.
The HUNT longitudinal study examined the number of chronic nighttime insomnia symptoms. Compared with participants reporting no insomnia symptoms, one symptom corresponded to RR 1.19 for chronic widespread pain, two symptoms to RR 1.78, and three symptoms to RR 3.08; the confidence interval for the one-symptom result included 1.
For pain-related disability, one nighttime insomnia symptom corresponded to RR 1.49, while three symptoms corresponded to RR 2.46. These are observational associations from the HUNT study, not estimates of population prevalence.
A separate systematic review through 2023 found no statistically significant pooled association in clinical populations between sleep disturbance and temporal summation of pain: the correlation was −0.00, with a 95% CI of −0.22 to 0.21. The pooled correlation with conditioned pain modulation was 0.12, with a 95% CI of −0.05 to 0.29, also not statistically significant.
Source: The Impact of Sleep Disturbances on Endogenous Pain Modulation.