As your hemorrhoids heal, it can be challenging to sleep. However, there are steps you can take to help alleviate the symptoms that can keep you up at night, all while supporting the healing process.
Hemorrhoids, also called piles, are small and swollen blood vessel-containing lumps that can develop in and around your anus.
While hemorrhoids usually heal within a few days without medical intervention, pain and discomfort are common. Hemorrhoid symptoms may also sometimes feel worse at night, making it difficult to fall and stay asleep.
Common symptoms of hemorrhoids include anal itching, pain, and overall discomfort. While there’s no clinical evidence supporting the theory that hemorrhoids cause more pain at night, anecdotal reports suggest that they can feel worse when you’re trying to sleep.
While most clinical studies have looked at the connections between chronic pain and insomnia, some of the findings may be relevant to explaining increased pain and problems with sleeping from acute conditions like hemorrhoids.
For example, in the case of chronic pain related to arthritis, researchers believe that associated pain can be worse at night because you might notice it more due to fewer distractions. Work and activities you have during the day may slightly distract you from hemorrhoid discomfort.
Also, a 2022 discussion of physical therapy and chronic pain noted that not getting enough sleep could actually lower your pain tolerance. In other words, you may experience a heightened sense of pain if you’re not getting enough sleep due to a medical condition.
Another consideration is that you might not necessarily use some of the methods commonly used to reduce hemorrhoid symptoms during the day, such as applying ice packs to the affected area.
The key is to help find relief so you can get sleep and support the healing process. Below are a few different tips you can try.
Drink plenty of water during the day
Constipation is also a common cause of hemorrhoids. If you’re currently experiencing constipation, consider remedying this by drinking plenty of water during the day. You should aim for at least
Eat more fiber during the day
Getting enough fiber in the diet is also important in alleviating constipation and hemorrhoids. At a minimum, males need
Reposition the hemorrhoid
Pushing a hemorrhoid back into your rectum if it has protruded may help you sleep better. However, this should not be done without the recommendation or guidance of a medical professional.
Take a sitz bath
Sitz baths involve sitting in small plastic tubs with warm water. These are sold at pharmacies and can be attached to toilets for easier use.
A sitz bath may be used
A warm bath alone may also help reduce pain. A 2019 research review also found that taking a warm bath or shower can help your body relax and improve your ability to sleep.
Apply topical cream
Over-the-counter (OTC) topical hemorrhoid creams may help address pain, swelling, and itching that can keep you up at night. Follow the package instructions, and apply one last time before bed.
Topical hemorrhoid creams may be used for up to
Wear loose clothes to bed
When you’re dealing with hemorrhoids, you should consider wearing loose, cotton clothing at bedtime, especially when considering pants and undergarments.
Cotton has long been a mainstay in terms of breathability, and
Take pain relievers
Taking OTC pain relievers on a temporary basis may also improve symptoms of hemorrhoids at night. Examples
- acetaminophen (Tylenol)
- aspirin
- ibuprofen (Advil, Aleve)
Keep in mind that depending on the type of drug, the effects may wear off after a few hours. Also, you should avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen if your hemorrhoids are bleeding.
Apply ice packs before bed
Ice packs or cold compresses may help numb your hemorrhoids and reduce inflammation. While you shouldn’t go to bed with ice, you may be able to help alleviate symptoms by using this method before bedtime.
Your sleeping position is another consideration for nighttime hemorrhoid pain relief.
While there’s a lack of clinical studies in this area, it might be helpful to avoid sleeping on your back when you have hemorrhoids to avoid further pressure on your bottom. Sleeping on your side may be another option to increase comfort.
However, it’s also important to understand that what’s considered a comfortable sleeping position is highly individual.
As one 2024 cross-sectional study of 375 adults with chronic low back pain found, most participants tried avoiding sleeping on their stomachs as a method of pain management. Yet researchers here also discovered that almost any sleeping position aggravated pain.
Until more studies confirm what is statistically most comfortable for sleeping with hemorrhoid pain, it may be best to try a position that is most comfortable for you and that induces sleep.
Hemorrhoid management during the daytime hours can also help the healing process, possibly leading to fewer symptoms at night. In some cases, hemorrhoids require surgical removal or nonsurgical treatment measures.
Depending on their severity, treatment options for hemorrhoids may include a
- OTC pain relievers
- OTC hemorrhoid cream
- rubber band ligation (
most common medical procedure for this condition) - surgical stapling
- surgical removal (hemorrhoidectomy)
- electrotherapy
- infrared coagulation
- electrocoagulation
- sclerotherapy
Read more about treating hemorrhoids.
See a doctor if hemorrhoid symptoms don’t improve within 1 week or if pain and discomfort is gradually getting worse during the day and nighttime hours. A doctor can also assess recurring cases of hemorrhoids.
You should also get medical help if you have excessive anal bleeding, severe pain, or symptoms of an infection, such as high fever. These may all be signs of a more serious case of hemorrhoids.
Hemorrhoids are known to be painful and itchy. While having these anal bumps is uncomfortable any time of the day, you might notice more symptoms at night when you’re trying to sleep.
Some of the same hemorrhoid treatments you use during the day, such as OTC creams, can help at night. You may also consider OTC pain relievers, changing your sleep position, and other measures to help you fall and stay asleep easier as the hemorrhoids heal.
If the situation doesn’t get better, or if you’re experiencing worrisome symptoms, consider speaking with a doctor.