The Healing Power of Sleep: Why We Ask About Rest in Endometriosis Care
Why Sleep Matters in Endometriosis Care
When you live with endometriosis, sleep isn't just rest, it is also recovery. Yet for many of our patients, sleep is one of the first things to suffer. As a clinician working with people navigating persistent pelvic pain, fatigue, and hormonal fluctuations, I’ve seen firsthand how deeply sleep affects pain, mood, and quality of life.
It’s why it is one of the things I always ask in consults. Not just "How’s your pain?" but also, "How’s your sleep?"
The Link Between Endometriosis and Sleep Disturbance
Research confirms what many patients have known for years: endometriosis is associated with significantly higher rates of insomnia, poor sleep quality, and daytime fatigue compared to those without the condition.
In fact, people with endometriosis are more likely to experience insomnia, and the severity of their pain is directly linked to sleep disturbance. We can all relate to that feeling, when you have a poor nights sleep and everything is amplified. Think of it like a volume dial, when your sleep is poor, the volume is turned up, compared to when you are well rested, and your volume dial is low. But it’s not just pain waking people up at night. Psychological factors like anxiety and fear of the impact of the disease also play a major role in sleep quality. This is often the invisible side to endometriosis, where people are up at night worrying about the next day and what it may bring.
From a clinical perspective, this creates a vicious cycle: pain disrupts sleep, poor sleep lowers pain thresholds, and the body becomes more sensitive to pain. Add hormonal changes and inflammation into the mix, and it can become a real problem.
What Poor Sleep Can Do
Poor sleep can impact a whole body, and multiple systems. Chronic sleep disruption:
Heightens pain sensitivity (hyperalgesia)
Worsens fatigue and brain fog
Increases inflammation and cortisol levels
Impacts mood, including higher rates of anxiety and depression
Reduces immune function and recovery
And all of this matters even more when the body is preparing for, or recovering from, surgery.
What We Ask in Clinic
When we check in on sleep, it’s not just about hours slept. We look at:
Sleep latency (how long it takes to fall asleep)
Sleep quality and depth
Night-time awakenings
Restfulness upon waking
Use of sleep aids or medications
Sometimes, this opens the door to conversations about mental health, physical pain, hormonal cycles, and daily function.
Simple Strategies That Can Help
Here are a few evidence-informed strategies we discuss:
Create a calming pre-bed routine: dim lights, avoid screens, and do something relaxing.
Regulate your body clock: aim for consistent bed and wake times, even on weekends.
Move gently during the day: regular movement can improve sleep quality.
Support the nervous system: try deep breathing, journaling, or a warm shower before bed.
Consider natural supports: peppermint or chamomile tea, magnesium, or melatonin (under guidance).
Manage pain proactively: layering heat, pacing, gentle stretching, or prescribed medication early.
The Role of Digital Tools
One thing we’ve learned from early Matilda data and co-design sessions at Matilda is that tracking sleep, pain, and energy together helps people connect the dots. Patterns emerge. Language shifts to "I’m learning and understanding what I need."
Digital tools can offer personalised reminders, sleep hygiene tips, and even bedtime routines tailored to flare-ups or surgery recovery phases. And they can prompt better conversations in clinic. This includes the use of wearable devices such as Oura ring or Apple watch.
Final Thoughts: Supporting Sleep Can Have a Big Impact
In all chronic diseases, including pelvic pain and endometriosis, we cannot afford to ignore sleep. It’s not an afterthought- it’s an essential part of the care. When we support sleep, we support the whole person: their pain, their mind, and their ability to recover and thrive.
So yes, in every consult, we’ll keep asking: "How are you sleeping?" Because in that one question lies a world of opportunity for improvement.
