Haemorrhoids don’t suddenly get worse at night, but several nighttime factors can make the pain, throbbing, and itching feel more intense. Common reasons include warmth and sweating around the anus, changes in your body’s natural clock that increase itching. Irritated skin or too much cleaning, as well as constipation and straining earlier in the day, can also contribute to discomfort, which makes it difficult to sleep.
But, once you recognise these triggers, simple steps like keeping stools soft and protecting the skin can bring real relief. With the right approach, you can ease the irritation and improve your chances of getting a comfortable night’s sleep.
What Are Haemorrhoids (And Why They Flare)?
Haemorrhoids are swollen blood vessels in and around the anus. They can be:
- Internal – inside the rectum, usually painless but may bleed.
- External – under the skin around the anus, often sore or itchy.
They develop when pressure builds in the rectal veins, commonly due to straining during bowel movements, chronic constipation, pregnancy, obesity, or sitting for long periods. The swollen tissue becomes inflamed and sensitive, and the surrounding skin can also get irritated. As per the NHS, bright red blood after wiping or in the toilet should always be checked, as not all rectal bleeding is due to piles.
Do Haemorrhoids Become More Painful at Night?
The haemorrhoids themselves don’t get worse at night; symptoms typically cause itching, pain, soreness, and general discomfort. There isn’t strong clinical evidence showing that they become physically worse at night, but many people do report that the pain and irritation feel more noticeable when trying to sleep.
One reason is that during the day you’re busy and distracted, but at night there’s nothing to distract you from the discomfort. Being still in bed can make the itching or throbbing more noticeable.
Not getting enough sleep can make you feel pain more strongly. If you’re already tired, the discomfort from haemorrhoids may seem worse. You might also be less likely to use soothing methods at night, like putting on cream or using a cold compress. As a result, your symptoms can feel more intense.
Why Haemorrhoids Feel Worse at Night?
Haemorrhoids do not actually get worse at night, but certain factors can make the discomfort feel stronger when you try to sleep. Lying down changes how blood and fluid move in your body, and without daily distractions, even mild irritation can seem worse. Your sleeping environment and evening habits also play a role.
Here are common reasons why symptoms may feel worse at night:
- Increased blood flow: Lying down reduces the effect of gravity, causing more blood to pool in the rectal veins and increasing pressure.
- Fluid retention: The body’s fluid balance shifts when you rest, which can lead to extra swelling in the haemorrhoids.
- Reduced distraction: At night, you’re still and focused, which makes itching, throbbing, or pain feel more intense.
- Sleep position: Lying flat on your back or in positions that press on the anal area can make haemorrhoids more painful.
- Warmth: A warm bedroom or heavy bedding can increase blood flow and worsen inflammation.
- Mattress texture: A harder or unsupportive mattress can create extra pressure around the pelvic area.
- Clothing: Tight underwear or restrictive sleepwear can irritate the area.
- Food before bed: Spicy meals, caffeine, or alcohol in the evening may trigger irritation or looser stools that worsen symptoms.
Together, these factors explain why haemorrhoid pain and itching can feel worse at night, even though the condition itself doesn’t suddenly get more severe.
Ways to Ease Haemorrhoid Pain at Night
The goal at bedtime is to calm irritation, reduce swelling, and set yourself up for a more restful sleep. Small adjustments in your daily habits can have a significant impact. Here are some practical ways to ease haemorrhoid pain at night:
- Stay hydrated during the day: Constipation is one of the biggest triggers for haemorrhoids. Drinking enough water throughout the day keeps stools softer and easier to pass, reducing the strain that worsens symptoms at night.
- Add more fibre to your diet: A fibre-rich diet (wholegrains, fruit, vegetables, and legumes) supports regular bowel movements and prevents constipation. Men should aim for about 38 g a day, and women around 25 g.
- Gently reposition a prolapsed haemorrhoid: If a haemorrhoid has slipped out of the rectum, carefully pushing it back in may relieve pressure and discomfort. Only do this if your doctor has advised it’s safe.
- Take a sitz bath before bed: Sitting in warm water for 10-15 minutes can relax the anal muscles, reduce swelling, and ease irritation. Doing this right before sleep can make it easier to rest. A warm shower or bath can have similar calming effects.
- Use a topical treatment: Over-the-counter haemorrhoid creams or ointments can reduce pain, itching, and swelling. Apply one last dose before bed, following instructions on the packaging, but don’t use them for more than a week without medical guidance.
- Wear loose cotton sleepwear: Breathable clothing reduces friction and keeps the area cooler, which helps prevent irritation during the night. Tight fabrics trap heat and moisture, making symptoms worse.
- Take pain relief if needed: Paracetamol (acetaminophen) is usually the safest choice. Ibuprofen or aspirin may help too, but avoid them if you’re experiencing rectal bleeding.
- Apply a cold compress before bed: Holding an ice pack against the area for a few minutes can numb pain and shrink swollen tissue. Use this method before lying down, not while sleeping.
- Choose a supportive, softer mattress: A very hard or unsupportive mattress can create pressure in the pelvic and anal area. A mattress with some cushioning helps distribute body weight more evenly, reducing strain and making it easier to find a comfortable sleeping position.
Best Sleep Positions When You Have Haemorrhoids
The way you sleep can make a difference to how comfortable you feel with haemorrhoids. Lying flat on your back often increases pressure on the anal area, which may worsen pain or swelling. Sleeping on your side is usually gentler and can help relieve some of that pressure, making it easier to rest.
There is no single best sleeping position. Everyone has different comfort levels, so it’s important to find a sleeping position that puts the least strain on your body and helps you fall asleep. Many people find it helpful to use extra pillows or cushions for support, especially to avoid lying directly on the affected area.
Treatment Options for Haemorrhoids
When home remedies aren’t enough, medical procedures may be needed. Common options include:
Rubber band ligation
In rubber band ligation, a small rubber band is placed at the haemorrhoid base to cut off the supply of blood, which causes it to shrink and fall off within a few days.
Haemorrhoidectomy
Haemorrhoidectomy is a surgical removal of haemorrhoids and is usually recommended for large or severe cases. It’s highly effective but has a longer recovery time.
Haemorrhoidal artery ligation (HALO/THD)
Haemorrhoidal artery ligation is a minimally invasive procedure where blood vessels feeding the haemorrhoids are tied off using ultrasound guidance, leading to shrinkage with less post-procedure pain.
Laser haemorrhoidoplasty (LHP)
Laser haemorrhoidoplasty is a modern method that uses laser energy to shrink haemorrhoidal tissue from within, offering quicker healing and less discomfort than traditional surgery.
What to Avoid?
Certain habits make haemorrhoids worse:
- Straining or sitting too long on the toilet.
- Over-cleaning or using fragranced wipes/soaps.
- Codeine-based painkillers (they constipate).
- Excessive alcohol, caffeine, and spicy foods in the evening.
When to Seek Medical Help?
You should contact a doctor if your haemorrhoid symptoms don’t start improving within a week, or if pain and discomfort keep getting worse, especially at night. Recurring haemorrhoids also need a proper medical assessment to prevent them from coming back.
Seek urgent medical care if you notice heavy anal bleeding, severe or persistent pain, or signs of infection such as fever. These can indicate a more serious condition that needs prompt treatment.
Final Thoughts
Haemorrhoids can be frustrating, especially when symptoms feel worse at night and disrupt your sleep. While simple steps like staying hydrated, eating more fibre, and adjusting sleep positions often help, persistent or severe cases may need medical treatment. Paying attention to triggers and seeking timely advice from a doctor ensures faster relief and prevents complications. With the right care, most people find their symptoms manageable and can return to a more comfortable daily routine.
Frequently Asked Questions
1. How can I sleep with haemorrhoids during pregnancy?
Try sleeping on your side to take pressure off your abdomen and rectal area. You can also lie face down with your knees tucked in for short periods to improve blood flow and ease discomfort.
2. What should I avoid during a haemorrhoid flare-up?
Stay away from low-fibre and greasy foods, don’t scratch or pick at haemorrhoids, avoid heavy lifting, and limit laxative use. Stress management also helps prevent worsening symptoms.
3. What causes haemorrhoids in pregnancy?
Haemorrhoids usually develop from extra pressure in the pelvic area due to the growing uterus, hormonal changes that relax blood vessels, and constipation, which makes you strain.
4. How can I stop haemorrhoids from hurting at night?
Take a warm sitz bath, use a soothing cream, and try pain relievers if needed. Sleep on your side with a soft surface, and wear loose clothing to reduce pressure and irritation.
