It always gets worse at night. Works the same way with the flu too. Ever notice when you are sick you can feel fine all day and as soon as the sun goes down your body gets all yucky again??

My nightly tramadol/ambien coctail helps with the pain at night and puts me to sleep. Problem is I still wake up at 3:30 every morning and most of the time I cannot go back to sleep so even with all of the meds I am still only getting 4-5 hours of sleep a night. I think it's because at night time we finally rest our bodies after being active all day.