People suffering from osteoarthritis experience more pain in their knees when they also have insomnia, according to a study conducted at Johns Hopkins University School of Medicine. Researchers found that people suffering from both painful knee osteoarthritis and insomnia were more likely to experience a nervous system disorder called “central sensitization, ” an ailment that causes patients to develop a lower pain threshold.
Insomnia Worsens Osteoarthritis Pain

Officials of the Centers for Disease Control and Prevention estimate that 52.5 million U.S. adults, roughly about a quarter of the population, suffer from arthritis. About one in ten men and one in five women over age 60 have osteoarthritis.
Unrelenting pain is a common complaint among patients with advanced osteoarthritis, and one of the reasons patients have total joint replacement, explains Santa Rosa Orthopaedics surgeon, Michael McDermott, M.D. “Joint replacement surgery is typically recommended to patients who have tried non-surgical treatment but still have joint pain.”
Knee osteoarthritis patients who sleep well (do not have insomnia) and are not plagued with constant chronic pain, function better than do those with the double whammy of insomnia and chronic knee pain.
The research revealed that the combination of lack of sleep, and the inability to find relief from constant pain caused by osteoarthritis causes people with knee osteoarthritis to not only suffer more pain, but to also exhibit poorer physical function when compared to knee osteoarthritis patients that do not suffer from insomnia.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
Join the conversation
Orthopedic professionals are discussing this. Sign in and upgrade to read every comment and add your voice.