I have had back pain for two years now — ever since I fell down a flight of stairs. I notice on the nights that I don’t sleep well, my pain is much worse the next day. It seems like this makes sense but what is really going on? How does sleep (or lack of sleep) affect pain?

These are the very same observations and questions a group of researchers at Johns Hopkins Medical School have been asking and studying. Clearly, there is a relationship between sleep and pain. Many studies have supported this view.

There’s even a day-to-day relationship. Sleep the night before affects pain levels the next day. But the relationship is even more complex than that. Younger adults who are overweight tend to report magnified pain. Likewise, patients with multiple other health issues also have more pain than those who have chronic pain alone.

We’re not sure there is a good explanation yet. Scientists think there is an overlap between neurologic, biologic, and pain-modulatory systems. Poor sleep seems to have the effect of arousing systems that regulate consciousness. Beyond that, there isn’t a clear understanding yet of just exactly what is happening.