Patients' experiences of chronic pain and sleep as a vicious circle: a qualitative explorative study from a pain rehabilitation setting.

OBJECTIVE: Chronic pain and sleep disturbances are common, interrelated conditions that substantially affect quality of life. Patients participating in interdisciplinary chronic pain rehabilitation programs frequently report sleep problems, yet patients' own experiences of sleep within this context remain insufficiently explored. The aim of this study was to describe experiences of sleep and pain among patients with diverse chronic pain conditions who have undergone an interdisciplinary pain rehabilitation program. METHODS: An explorative qualitative descriptive design was applied. Data were collected through focus group interviews and individual interviews with patients participating in an interdisciplinary pain rehabilitation program. The data were analysed using reflexive thematic analysis. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS: The bidirectional relationship between pain and sleep was a central aspect of participants' daily lives. The overarching theme, A vicious circle with two inseparable conditions, reflects how participants experienced pain and sleep disturbances as closely intertwined and difficult to distinguish. Three interconnected themes further described these experiences: Struggling with the interplay between pain and sleep; Striving for balance and meaning in daily life; and Needing understanding, support, and self-compassion. Participants described fragmented sleep, persistent fatigue, and continuous disruption of rest by pain, alongside ongoing efforts to manage everyday life under these conditions. An emotional burden was evident, characterized by self-doubt and questioning the legitimacy of their suffering. CONCLUSION: The findings illustrate how chronic pain and sleep disturbances coexist in a mutually reinforcing vicious cycle that significantly impacts quality of life. By elucidating the practical, emotional, and social dimensions of these experiences, the study contributes to an extended understanding of chronic pain from a patient perspective. The results underscore the importance of integrating sleep hygiene practices, sleep ergonomics, and holistic, patient-centred approaches within interdisciplinary chronic pain rehabilitation programs.