Modern pain science increasingly recognises sleep as more than a passive period of rest. Sleep represents an active biological process involved in nervous system regulation, tissue repair, immune modulation, and maintenance of physiological resilience.

Consequently, effective long-term pain management may require consideration of sleep quality alongside other contributing factors, including physical activity, stress physiology, autonomic regulation, metabolic health, and broader lifestyle influences.

Contemporary research has demonstrated that persistent pain can involve complex interactions between the nervous system and immune system, including altered cytokine signalling, glial cell activation, and dysregulated inflammatory responses (Ji et al., 2016). These processes may contribute to heightened nervous system sensitivity without producing abnormalities on routine pathology screening.