When You Can’t Sleep After Knee Replacements


I’ve been busy working on my latest novel, so my advance apologies for lack of entries.

It’s been four months today since I underwent right total knee replacement surgery and things continue to go well. I’m able to walk two miles without stopping, something that was painful to do before January 12, 2015. My left knee gives me trouble on occasion, but that will also become a thing of the past sometime this fall or early winter.

Today I’d like to discuss something those of us who had TKR often have in common: our sleep patterns disrupted in the early weeks following surgery. Many with brand new knees, hips, or whatever other joint-related surgery) often voice post-op concerns about little or no sleep.

I can say for sure it’s not happening during hospital stays and forget about having much sleep time at a rehab facility as well (because rehab facilities are for learning to use our new joints after all). Lighthearted references aside, lack of sleep after joint replacement surgery is no joke. Our bodies need time to recover from the trauma it’s been through: loss of a natural joint, adjusting to the implant, blood loss, anesthetic, pain…you get the idea.

Bonesmart.org offers additional contributions to sleep deprivation stemming from pre-op to returning home following surgery. This is a great read I highly recommend.

Bonesmart also offers the following tips on coping with disturbed sleep patterns:

The main trick is to not let it get to you. There’s a joke saying “It’s mind over matter – if you don’t mind, it won’t matter”!

Be prepared for this and determine that you are NOT going to let it get to you

Give yourself permission to nap anytime and anywhere you feel you can

Some TKR patients have used melatonin to help produce sleep. This supplement is a safer alternative to prescription or over the counter sleep medications. Pain medicine may work for some, but it’s not a good idea to always use it simply to sleep – unless of course you’re in actual pain that can’t be controlled by Tylenol or Aleve. Small doses of Benadryl may help, but it’s not for everyone (especially those with allergies to its specific ingredients)

If you’re still feeling “wiped out” after surgery, this graphic I found on a Facebook group sums up everything well:



Most important, post-op sleep disturbance is often temporary. This too shall pass, I promise!

However, should problems continue, have a discussion with your doctor for other options. Sleep is an important factor for our bodies to recover from such traumatic surgery.


12 thoughts on “When You Can’t Sleep After Knee Replacements

  1. Coming up on my 6th week post op bilateral knee. Nap throughout the night and day. So freaking uncomfortable from the popping, grinding and painfull movements still!!! That it is painful no matter what!! I have been busting my hump to get back into service. It seems the more forward I go the more I go back.

    p.s. I forgot to mention that I am a 43 yr old male with some long hard miles who now supports my family as a firefighter paramedic with 13 yrs of service and no chance of retirement.


    • Hello Tim, When I read your comment I felt I had to reply. I think you are pushing yourself too fast and too hard. I just had a total knee replacement on January 26th. I am 64 years old and have raised 4 children. I have had several surgeries in my lifetime and I am no stranger to pain. I see myself as “super-woman” who can handle anything life throws at me. I thought I would be back to normal in 4-5 weeks. My point is that, much like you, I am not recuperating as quickly as I thought I would and it is frustrating and depressing. Maybe you and I need to relax a little and give our bodies time to rest and heal and stop being so demanding on ourselves. I wish you the best of luck.


    • Had surgery 11-28-16. All is going well except sleep. Had tried all prescriptions and over the counter meds. Yesterday took 9 mgs. of melatonin, slept like a baby, first time since surgery. Highly recommend it. Also, dont allow your PT to push too hard, if its too painful dont do it. John.


  2. Hi, I had a,total right knee replacement 3 month ago ,still have ,it have terrible pain at bed time an truly sleep deprived ,I have tried ice packs ,pillow and what ever ,not only does the knee area hurt ,the whole leg down to my toes ,so very frustrated. Well take any suggestions.
    Thank you Deb


    • My right knee replacement was 7 weeks ago today. Everything Deb says apples to me. Also I get very little sleep. Last night got 3 hours. This is driving me crazy! Trying to find out how long this is expected to go on 😁Linda


      • Linda, So sorry you are going threw this ordeal, My surgery was December 29th I still have difficulty sleeping ,I have a nagging pain ,since yesterday day had physical therapy. Walked 6000 steps and today did almost 5000 steps and I’m still in awful pain now , I hear how other are doing so well. I asked my therapist what I’m doing wrong because I don’t understand how it could be this long this much pain and uncomfortable , she keeps reassuring me that this is normal some people take longer than others he says now if we’re already into a year then I say we have something to worry about I can’t even go shopping for a. Of time or do the things I need to do in my home this is too much before you 7 weeks that’s not bad I’ve heard more people do much better after the eighth week ,so I’m praying for you that you get much better soon. Because no one should have to suffer the purpose of this new surgery was to be out of pain, I don’t see that light at the end of the tunnel for myself, for you I hope you do very well and I hope to keep in contact with you thank you Linda for answering my comet. On May 3, 2016 2:39 PM, “L. Anne Carringtons Journey To New Knees” wrote:

        > Linda spencer commented: “My right knee replacement was 7 weeks ago today. > Everything Deb says apples to me. Also I get very little sleep. Last night > got 3 hours. This is driving me crazy! Trying to find out how long this is > expected to go on 😁Linda” >


      • Thanks for your reply, Debra! Comparing notes with others in the same boat is helpful😊I hope we both get much better soon. As you correctly said, the purpose of this is to be pain free.keep in touch! Linda


  3. I had my right knee replacement on Mar 14. I was through with therapy my 8th week. She said I just need to work on my strength. I did extremely well and I have to have the left knee done next and pray I do as well. I still take naps. And I do my exercises 1-2 times a day. My Dr even sent me to therapy before my surgery. That is one of the most important things – keep doing the exercises. My pain is completely gone. I still get “sore” from exercising but that is normal. As they told me – keep moving and you will do much better.

    Good luck to everyone.


  4. I had TKR on October 13th. I am almost 7 weeks post op! Still can’t sleep at night and still have pain. I really under estimated this recovery. I had hoped to see from this blog how long it takes people to start sleeping at night and to be out of pain but really am not getting the answers I had hoped for. The area around my incision feels raw like someone has scraped it with sand paper. I have tried using marijuana cream (which is legal in WA State) on the affected area and it has helped some. I just wish I was out of pain and the swelling was gone. Anyone else having these issues?


    • I had a TKR in July and it,went great…very little pain for about a week…and then none at all…and sleeping at night was fine…I went so well that I decided to,have the second knee replaced on 22 November 2016.. Two and a half weeks,ago…same thing went great I have no pain whatsoever and do not take meds..walking normally… going to PT…but,t I cannot sleep at night…did not happen with the first TKR.. Sometime I take Lunesta 1/2 mg …i cut the 1 mg into 2…and that lets me sleep…but I do not want to rely on pills,even as little as 1/2 mg…..usually swim a lot 45 min per day …but of course I cannot do this right now….
      How long will the insomnia last????


      • Hi Maggie: First of all – you are so very lucky to have BOTH TKR’s behind you now! And…..to have no or very minimal pain is amazing. I am now at week 8 and still have pain and STILL not sleeping thru the night. I ice my knee before bed, take 2 pain pills and still wake up in about 3 hours with pain and toss and turn until I can get into another position that doesn’t hurt. Right now the skin area around the incision feels like somone sanding the skin with sandpaper or burning it with matches. I am thinking it is the nerves coming back to life. I really had hoped to have my second knee done in January but I want to feel normal and have no pain for a couple of months anyway before getting the other one done. Right now, I feel like I will never feel normal again. I have heard that the 3 month mark will make a huge difference and I am looking forward to getting there. I hope and pray this will be a faint memory soon.


  5. Sandi R back again. Three months post op! Finally decided to ask doctor for sleep aid at night since my pain pills were gone. He prescribed Ambien – worked the first night because I think I was so exhausted, but didn’t work the next 2 nights so I went back to my 5 mg of Melatonin and Aleve PM which does just as good. I still wake up every couple of hours with slight pain on the inside of my knee (where the new knee connects to the leg bone). Still using marijuana cream on the incision area but that sorness is becoming better. I have scheduled my next knee replacement for April 13th and hope by then that I am at 100% on my right knee. Not quite there yet. PT stopped the end of December but I am doing exercises at home.


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