By Senior Physiotherapist Rob Barker.

Why sleep is so important in recovery and healing.

We all know getting a good night sleep makes us feel better including being more alert. But, why is getting a good night sleep important for our bodies to function properly and increase our immune health? We spend a third of our lives asleep, so by the time we are 70 years old we would have slept for a total of approximately 25 years!  Research has shown sufficient sleep:

  • Improves wound healing effects
  • Reduces body inflammation
  • Reduced our pain responses to injury.
  • Improves cognitive function and memory.
  • Improves immune function.   
  • Improves hormone secretion and regulation, such as cortisol (which regulates are bodies response to stress among other things)
  • Increases our bodies glucose metabolism
  • Regulates our body temperature.

A lack of sleep has also shown to increase a number of inflammatory cells, such as leukocyctes and monocytes, that leads to an overactivity of our immune response and higher levels of inflammation in our tissues and organs.

What is inflammation?

Inflammation is a natural protective response by the body to help attack and fight off harmful pathogens, such as viruses, bacteria’s and certain toxins. These pathogens can cause diseases and reduce the bodies healing natural power. When our bodies are in the phase of ‘acute inflammation’ we are in the process of fighting the pathogen, sending all the inflammatory cells to the area to help combat the threat. Issues occur when are body’s natural inflammatory process start occurring to often and for not the right reasons and inflammatory cells then start attacking the bodies healthy cells and tissue, leading to a chronic inflammatory response. Poor sleep has shown to be a strong contributor to chronic inflammation.

So how are sleep and inflammation related?  

Sleep and inflammation share are common regulator in our bodies called circadian rythms. These circadian rythms help regulate sleep by driving hormones and physiological changes along a constant continuum of sleep and awake in a normal daily pattern. Circadian rythms also regulate the body’s immune system and thus can increase inflammation if they are disrupted by not maintaining a healthy sleep/wake routine. If our sleep cycles are disrupted or we have insufficient sleep, we have a stronger immune response. So by keeping a steady sleep routine of going to bed and walking up at a similar time daily, we can maintain healthy circadian rythms. Simple!

Also, as little as one bed night sleep can increase certain proteins within our body that initiate pro-inflammatory state. CRP (C-Reactive protein) is a protein which the liver secrets in response to an inflammatory signal. This CRP has shown to be elevated in people with heart disease and diabetes, suggesting CRP is an important predictor of heart disease. CRP has also shown to be elevated in people with sleep deprivation, suggesting lack of sleep can be linked to increase risk of heart disease and diabetes….

It is not only the amount of sleep we get, but the quality of our sleep that effects our immune system. Poor sleep quality (lack of deep sleep) has shown in several studies to increase monocyte production, suggesting poor quality and interrupted sleep patterns can lead to increased inflammatory cells and lower our immune response.

The Sleep/pain relationship

Pain and particularly chronic pain is linked with poor sleep.  There are certain key mechanisms and process which are believed to cause an increase in someone’s pain response due to lack of sleep. These include:

  • Altered dopamine signalling
  • Altered opioid signalling
  • Psychosocial negative and positive affects. 

OK so this where things start to get interesting and slightly confusing, so hang in there!

Dopaminergic Signalling

Dopamine (DA) is neurotransmitter responsible for behavioural drive for pleasure, as well as maintenance of arousal states and aiding regulation of our sleep/wake cycle.

DA receptors are stored in the area of the brain where sleep modulation occurs. It has been theorised that seretonic cells, which signal alertness can become disrupted in pain states and contribute to sleep loss. Serotonergic and dopaminergic neurotransmission has a known interaction in arousal states, therefore it is viable that pain induced changes in DA signalling can influence the modulation of sleep/wake cycles.

Opioidergic signalling

It is believed that lack of sleep can dysregulate opioid systems and impair the analgesic capacity of our opioid receptors. Opioid receptors are also located in the same area of the brain that regulate our sleep cycles and pain. Sleep deprivation may alter the ability of these areas to maintain opioid receptor function and thus diminish opioid levels and dampen central opioid receptors leading to a heightened feeling of pain.   

Negative and Positive Affect

Studies have shown that an increased negative affect (moods/emotions) can explain variances between sleep disturbances and pain. Negative mood controls the balance between sleep and pain, especially in people with back pain, meaning the more negative mood we have, the less sleep we get and thus more pain we feel.

At the opposite end is positive effect (good mood), which has been shown to act as a buffer in the relationship between negative effect and pain. Positive effect promotes resilience both physically and psychosocially in chronic pain patients and those suffering from sleep disturbances.

So what’s ‘adequate’ sleep? I hear you asking.

Evidence suggests for the adult population, 7-8 hours of non-interrupted sleep per night is optimal for peak bodily function. Shorter and longer duration sleep has to been linked with higher health risks, impaired immune response, increased inflammatory responses, and also cardiovascular disease and diabetes.


If you would like to make a physiotherapy appointment and get some basic advice in regards to sleep, please call the clinic on 9756 7424 or book online  for an initial assessment. .

Cancellation Policy

We have a same day cancellation policy where a $50 fee will be charged for missed or cancelled appointments. Please call 9756 7424 or email to reschedule or cancel Thank you for your understanding.

Book a Physiotherapy appointment @ Dunsborough Book a Physiotherapy appointment @ Nannup Get the '4Lane Physio' App - iPhone 


Simpson, N & Dinges, D. F. Sleep and inflammation. Nutrition reviews. 2007: 65(12), 244-251.

Finan, P. H., Goodin, B. R., & Smith, M. T. The association of sleep and pain: An update and a path forward. J Pain. 2013: 14(12), 1539-1552.