Sleep thought swaps

When sleep is disrupted, your pain can become worse and you may feel tired and less able to do things over time. Remember, the way you think, feel and act are linked, so sleep is very important.

When you have chronic pain, you may have trouble getting to sleep, staying asleep, or you may need to nap during the day. You might start getting up later and later each morning to catch up on sleep, which can upset your body clock and your daily routine.

When you are exhausted and can’t get to sleep, you might focus on negative thoughts, how hard life is and all the worries you have. You might think that not getting enough sleep will ruin your day, make your pain worse and you may decide that it is better to stay in bed longer or nap more to catch up on the sleep you have missed.

Thoughts are often categorised as positive or negative, but it is more useful to think about thoughts as helpful or unhelpful. Helpful thoughts allow you to deal with your problems and meet your goals. Unhelpful thoughts make you feel worse and can lead you further away from your goals.

It can be hard to find helpful thoughts when you’re cannot get to sleep or you are in pain. There is no point denying what is going on – but there is a more helpful way to think about this?

‘Yes, I am struggling to get to sleep and I am in pain, but the best way for me to deal with this is to stay calm, stop getting stressed and remind myself that I will fall asleep, the pain will pass and I will be okay.’

This is more helpful to you than becoming worried or agitated, thinking that you will never get to or stay asleep or that the pain will never go away.

What kind of thinking would you prefer?

Sometimes it’s hard to stop those unhelpful thoughts, it can be easier to swap these for more helpful thoughts. Look at some examples below.

In the first column there are some common unhelpful thoughts you might have about your sleep. These are thoughts that other people in chronic pain have said that they have – are these thoughts familiar to you?

Next to these are some more helpful thoughts – you can call these thought swaps – these are thoughts that you can swap for your unhelpful thoughts about sleep. Read through the different thoughts below to see which ones work for you.


I will never get to sleep, my pain is too bad.

It might take me a while to get to sleep, but I will. Listening to a meditation will help me to relax.

I have not had enough sleep – I will be too tired tomorrow and my day will be ruined.

I have had less sleep than I would like, but I can still have a good day if I plan my activities around my energy levels and pace myself.

Even when I get to sleep, I will wake up due to my pain and it will be worse.

My pain does not always wake me up. Even if it does wake me up, it is better to have some sleep now.

I know I have to get up, but I have slept so poorly, it will be better to stay in bed to catchup on some sleep.

I might have slept poorly, but it is better to get up at the same time each morning to help my body clock get into a better pattern. This will help me to manage my pain in the long run.

This afternoon I am so tired, I need to have a long nap.

I am tired now and maybe a short nap might help, but I will not nap for too long because this will mess up my sleep tonight.

I am too tired to deal with the day or my pain. It will be easier to stay in bed.

It is hard managing my pain when I am tired, but if I get up and start my day slowly that will help my pain and sleep in the future.

Now it is your turn to create your own thought swaps. They work better when they are personal to you. Take a moment to think of one of your common thoughts about your sleep. Then check out the Sleep thought swaps guide to learn how to swap your unhelpful thoughts for more helpful ones using the My sleep thoughts swap worksheet and learn to Be Pain Smart.

Use the links below to download the files