When Aches & Pain Disrupt Sleep: Medication Chart

There is no perfect treatment for pain and sleeplessness. It all depends on your particular case -- the kind of pain you have and the other medications you take, for instance.

The first step for anyone with sleep problems is to improve their sleep habits. This helps set the stage for a good night's rest.

You might also benefit from medication. Some drugs ease pain, which can help with sleep. Other medicines are available to just aid sleep problems. Many people need both. But don't treat chronic pain and insomnia on your own. Over-the-counter drugs are not intended for long-term use. Instead, talk to your health care provider so you can get a personalized treatment plan.

Here are some of the drugs that help people with chronic pain feel better and get some rest.

 

Drug Class Benefits Risks

Over-the-counter NSAIDs

(nonsteroidal anti-inflammatory drugs)


 

Relieves pain and reduces swelling Side effects include a risk of ulcers and bleeding. Not for long-term use unless recommended by your health care provider. Take with food.
Over-the-counter acetaminophen

Relieves pain They can also cause liver toxicity in high doses. Not for long-term use unless recommended by your health care provider.
Over-the-counter combined sleep aids/pain drugs

  • Advil PM (ibuprofen and diphenhydramine)
  • Tylenol PM (acetaminophen and diphenhydramine)
Relieves pain and helps with sleep These drugs help you sleep by including an antihistamine, an ingredient in cold medicines that may also work as a sedative. However, according to the National Institutes of Health, the effectiveness of antihistamines as a sleep aid is not well established and they can have side effects like daytime drowsiness and decreased cognitive function. Not for long-term use.
Opioid painkillers

Relieves more severe pain Side effects include nausea, constipation, and a risk of addiction. Some of these medicines can disrupt the natural sleep cycle, reducing the amount of deep sleep you get.
Muscle relaxants

Relieves more severe pain Relieves pain from spasm and helps with sleep. Side effects include drowsiness, dry mouth, constipation and confusion. Should not be used for long-term pain relief.
Benzodiazepines
Used to reduce anxiety, benzodiazepines can also aid with sleep. These drugs are not for long-term use. Side effects can include daytime sleepiness, cognitive impairment, and dependence/addiction. They can also reduce the amount of REM sleep.
Nonbenzodiazepine hypnotics

Aids with sleep, while not causing the same disruptions to the sleep cycle that benzodiazepines do; they are generally considered to be safer for longer use. Side effects can be similar to those of benzodiazepines, although generally less severe.
Anticonvulsants

Originally used to prevent seizures, these drugs can also help with nerve pain. Side effects include drowsiness and dizziness. You should never stop taking these medicines abruptly.

Antidepressants

 

Reduces pain, particularly for headache, nerve pain, and fibromyalgia; some can aid sleep.

Cymbalta is approved for musculoskeletal pain.

These drugs may not be effective for other types of pain, like sports injuries or back pain. Antidepressants are powerful drugs that can have serious side effects. Talk to your health care provider about side effects you should watch out for.
WebMD Medical Reference Reviewed by David Kiefer, MD on June 29, 2016

Sources

SOURCES: American Chronic Pain Association web site, ACPA Medications & Chronic Pain Supplement 2005. Penney Cowan, executive director, American Chronic Pain Association. Gilles Lavigne, DDS, MSc, FRCD, professor in dentistry, physiology and psychiatry, University of Montreal. Principles and Practice of Sleep Medicine, 4th edition, 2005. National Institutes of Health web site, National Institutes of Health State-of-the-Science Conference Statement, Manifestations and Management of Chronic Insomnia in Adults, June 13-15, 2005. National Sleep Foundation web site: "Pain and Sleep." National Sleep Foundation web site: "Pain and Sleep: Gilles Lavigne interview." Thomas Roth, PhD, director, Sleep Disorders Center, Henry Ford Hospital, Detroit. Shaw, R. et al., Sleep 2005. WebMD Health News: "FDA Approves Cymbalta for Chronic Musculoskeletal Pain."

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