Sleep Is Medicine for Pelvic Pain

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By: Maryssa Steffen, DPT, PHRC Berkeley

If you experience pelvic pain, are you aware of how your sleep quality may play a part?  A 2015 national poll by the National Sleep Foundation found that “64% of those suffering chronic pain, and 54% of those with acute pain, report co-occurring poor sleep quality.”1

Everyone needs seven to nine hours asleep in bed. As Matthew Walker, the director for the Center of Human Sleep Science at the University of California, Berkeley, said, “In case you’re wondering, the number of people who can survive on five hours of sleep or less without any impairment, expressed as a percent of the population and rounded to a whole number, is zero.”2

If you have difficulty falling asleep, staying asleep, or if you do not wake up refreshed, then you may benefit from a sleep study. During a sleep study, your doctor will gather data while you doze. It is a non-invasive, overnight exam that measures the activity of your brain and body. It will identify possible disruptions in the pattern of your sleep when it fluctuates between deep sleep and dreaming states. Sleep studies are comprehensive and measure items such as eye movements, oxygen levels in your blood, heart and breathing rates, snoring, and body movements. After the data is collected, a follow-up with the doctor is scheduled to discuss the results.3

During uninterrupted sleep, your body enjoys restorative rest and low muscle activation.  This reduced tone and increased relaxation of the body promotes healing and recovery. In 2015, a study done by Siversten et al., concluded that “sleep problems significantly increase the risk for reduced pain tolerance.” If you are experiencing pain, one of the best remedies is a good night’s sleep. Sleep decreases your pain sensitivity. A recent study found that even small gains in sleep quality can improve patient’s report of pain.5

If you are experiencing pelvic pain, you may benefit from manual therapy and exercises provided by a pelvic floor physical therapist in one of the PHRC clinics. A good pelvic floor PT would help to decrease the musculoskeletal tension that might be contributing to your pain. Physical therapy can help you function with more ease during your day and sleep will help restore and heal you.

If it takes more than 20 minutes for you to fall asleep on most nights, it is recommended that you practice habits called sleep hygiene.6 Here are tips for sleep hygiene:

  • Maintain regular bedtimes and rising times. Wake up at the same time each morning regardless of the amount of sleep obtained that night. This will help set your natural biological clock.    
  • Expose yourself to natural light during the day to regulate your natural biological clock.
  • Limit your daytime naps to 30 minutes, and if possible, nap before 2 pm.
  • You want your bedroom to be comfortable and relaxing and should only be associated with sleep or sex. If you cannot fall asleep within 20 minutes, leave the bedroom and return only when sleepy.
  • While in bed, avoid too much light and disturbing noises. Use ear plugs, light-blocking curtains, or an eye mask if needed.
  • Keep your bedroom cool. If it is a hot night, try a warm bath because that will expand your blood vessels and help you cool down as the heat leaves your body.
  • Use a comfortable and supportive pillow and mattress. If you cannot relax in bed, try various pillows, wedges, and the right mattress to position you for a good night’s sleep. 
  • Avoid un-prescribed or over-the-counter sleep aids. These drugs can disrupt your deep sleep. You may need to discuss your medications with your doctor.
  • Avoid caffeinated foods and drinks at least four hours before bedtime (includes most tea, coffee, chocolate, and soft drinks). It takes caffeine 24-36 hours to completely leave your system!  Refrain from drinking alcohol or smoking at least three to four hours before bedtime.
  • Avoid stimulating activities right before bedtime, including watching TV or discussing a stressful topic. Be mindful of your LED displays, including cell phones, because the blue light emitted from electronics disrupts sleep two to three hours before bed.7
  • Try to eat a large meal or consume spicy food and drink fluids more than two to three hours before bedtime. This practice will decrease waking up in the middle of the night to use the restroom. If you are too hungry before bed, a light snack is OK.
  • Exercise regularly, preferably moderate to vigorous intensity. Meta-analysis indicates that an exercise routine has a significant positive impact on deep sleep states (restorative sleep), total sleep time, and decreases the amount of time it takes to fall asleep.
  • Try to get your exercise more than two to three hours before bedtime so that your body has sufficient opportunity to cool down and relax. 
  • Develop a sleep ritual such as maintaining a 30 minute relaxation practice.  Everyone’s relaxation methods are different. Some suggestions include a warm bath, reading a book, meditation, mindfulness, stretching, yoga, progressive muscle relaxation, abdominal breathing, imagery, etc.
  • Here is a great blog that describes the benefits of meditation:

If these tips are a bit overwhelming, think of someone who practices sleep hygiene. Do they give themselves an uninterrupted, eight hour sleep opportunity every night?  Maybe they can inspire you! 

“The truth is, a lot of those emails can wait until tomorrow, while a good night’s sleep cannot.” – The National Sleep Foundation



  4. Sivertsen B, Lallukka T, Petrie KJ, Steingrimsdottir OA, Stubhaug A, Nielsen CS. Sleep and pain sensitivity in adults. Pain. 2015; 156(8):1433-9. DOI:10.1097/j.pain.0000000000000131
  5. Krause J. Neurosci 2019; 10.1523/JNEUROSCI.2408-18.2018
  8. Kubitz, K A, D M Landers, S J Petruzzello, and M. Han. “The Effects of Acute and Chronic Exercise on Sleep. A Meta-analytic Review.” Sports Med 21.4: 277-91.


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