This review critically examines the recent prospective and experimental literature (2005-present) on the association between sleep and pain to update the field on emerging themes regarding the directionality and mechanisms of their relationship. Key findings suggest that sleep impairments reliably predict new incidents and exacerbations of chronic pain, with sleep disturbances being a stronger predictor of pain than pain is of sleep. Microlongitudinal studies using deep subjective and objective assessments support this notion. Experimental studies indicate that sleep disturbance may impair key processes contributing to the development and maintenance of chronic pain, including endogenous pain inhibition and joint pain. The review discusses several biopsychosocial targets for future research, including dopamine and opioid systems, positive and negative affect, and sociodemographic factors. The findings highlight the importance of targeting sleep disturbance as a primary prevention and intervention strategy in chronic pain management.This review critically examines the recent prospective and experimental literature (2005-present) on the association between sleep and pain to update the field on emerging themes regarding the directionality and mechanisms of their relationship. Key findings suggest that sleep impairments reliably predict new incidents and exacerbations of chronic pain, with sleep disturbances being a stronger predictor of pain than pain is of sleep. Microlongitudinal studies using deep subjective and objective assessments support this notion. Experimental studies indicate that sleep disturbance may impair key processes contributing to the development and maintenance of chronic pain, including endogenous pain inhibition and joint pain. The review discusses several biopsychosocial targets for future research, including dopamine and opioid systems, positive and negative affect, and sociodemographic factors. The findings highlight the importance of targeting sleep disturbance as a primary prevention and intervention strategy in chronic pain management.