Anal pain that prevents you from sleeping may be related to thrombosed hemorrhoids, perianal abscess, anal fissure, and other causes that require further differential diagnosis by a doctor. 1. Thrombosed hemorrhoids: when blood gathers on the external hemorrhoids to form a thrombus, it can lead to hard lumps around the anus, obvious swelling and severe pain. 2. Perianal abscess: often manifested as skin lesions in the anal or rectal area, which can cause itching, severe pain, swelling or fever. 3. Anal fissure: the main symptoms are perianal pain, constipation, bleeding during defecation, and the pain may be severe enough to prevent sleep. Anal pain can not sleep, there may be other reasons, such as anal cancer, rectal tumors and other diseases caused by the complexity of the causes, can not be a single symptom to determine what disease; it is recommended to go to the hospital in a timely manner, detailed examination, differential diagnosis and clear causes, standardized treatment under the guidance of the doctor, so as not to delay the condition.