Why Does Inner Knee Pain Occur When Sleeping?

Reviewed by Garrett Kneese, MD, MPH

Family Medicine

Inner knee pain during sleep is often linked to joint issues like osteoarthritis and poor sleep quality. The pain can worsen at night due to inflammation, joint pressure, and the body’s reduced distractions from discomfort.

Explanation

When you notice pain on the inside of your knee while sleeping, one possible reason is osteoarthritis, a condition where the joint wears down over time. Studies have found that as knee osteoarthritis gets more severe, people often experience more night pain. Inflammation in the joint can increase when you lie down, adding pressure on the knee, which affects sleep quality. When you are asleep, the lack of movement may cause stiffness and discomfort in the knee, especially if the joint’s inner part (the medial side) is affected. Additionally, poor sleep quality itself can make the pain seem worse. Restless sleep or disturbed sleep can lead to a cycle where pain and lack of sleep make each other more pronounced. Keeping your legs comfortably supported with pillows may help, as it could relieve extra pressure on the knee during the night. Always talk with your doctor if the pain continues or worsens, so they can help find the best way to ease your discomfort.

(References)

Dai Z, Neogi T, Brown C, Nevitt M, Lewis CE, Torner J, Felson DT. Sleep Quality Is Related to Worsening Knee Pain in Those with Widespread Pain: The Multicenter Osteoarthritis Study. J Rheumatol. 2020 Jul 1;47(7):1019-1025. doi: 10.3899/jrheum.181365. Epub 2019 Nov 15. PMID: 31732550; PMCID: PMC7225049.
Sasaki E, Tsuda E, Yamamoto Y, Maeda S, Inoue R, Chiba D, Okubo N, Takahashi I, Nakaji S, Ishibashi Y. Nocturnal knee pain increases with the severity of knee osteoarthritis, disturbing patient sleep quality. Arthritis Care Res (Hoboken). 2014 Jul;66(7):1027-32. doi: 10.1002/acr.22258. PMID: 24470323.
Lapane KL, Shridharmurthy D, Harkey MS, Driban JB, Dubé CE, Liu SH. The relationship between restless sleep and symptoms of the knee: data from the Osteoarthritis Initiative. Clin Rheumatol. 2021 Jun;40(6):2167-2175. doi: 10.1007/s10067-020-05531-4. Epub 2021 Jan 7. PMID: 33411138; PMCID: PMC8127344.

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