By Natasha Persaud

Here’s a novel strategy to reduce your feelings of pain: change your attitude. Preliminary research, published in the journal Pain, reveals that dwelling on pain before sleep promotes sleep disturbance and that, in turn, contributes to greater feelings of pain during the day.

Sleep Image - Masterfile

Worry is one component of so-called "pain catastrophizing," a negative response to pain involving rumination, helplessness and magnification. Surprisingly, in this study, feeling helpless or magnifying the problem did not promote pain, while focusing frequently on pain and thinking more negatively about it did. In the end, worry was more predictive of pain perception than depression.

What’s the remedy? The researchers suggest cognitive behavioral therapy (CBT) may reduce pain catastrophizing. In CBT, a person develops skills that challenge and soothe overly negative thoughts about pain. CBT involves a combination of talk therapy to address negative thought patterns and behavioral therapies to reduce stress, manage anxiety and aid sleep.

"If cognitive behavioral therapy can help people change the way they think about their pain, they might end that vicious cycle and feel better without sleeping pills or pain medicine," suggests Luis F. Buenaver, Ph.D., an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and the leader of the study, according to a news release.

Adopting good sleep hygiene can't hurt either.

The Pain study involved more than 200 people, primarily women, with jaw pain (temporomandibular joint disorder, TMJ disorder, TMD). Buenaver suggests the results also may pertain to other stress-related ailments such as fibromyalgia, irritable bowel syndrome (IBS), and some headaches, neck and back pain.


News release, Johns Hopkins Medicine

Buenaver, et al. Evidence for indirect effects of pain catastrophizing on clinical pain among myofascial temporomandibular disorder participants: The mediating role of sleep disturbance. Pain, published online March 2012.

Publication Review By: the Editorial Staff at

Published: 18 May 2012

Last Modified: 10 Nov 2014