Sleep deprivation experiments suggest that sleep disturbance may cause hyperalgesia. Few studies have assessed whether acute-pain related insomnia predicts the development of chronic pain. This study's objectives were to 1) describe the two year course of clinical pain following hospitalization for burn injury and 2) evaluate whether in-hospital sleep onset insomnia modifies the trajectory of clinical pain report. We analyzed data on 524 subjects hospitalized for major burn injury (74.8% male; mean age = 40.1 years +14) who were participating in an ongoing multi-site burn injury outcome study. Subjects completed various self-report measures of health and function (SF-36) and psychological distress (Brief Symptom Inventory: BSI) while in-hospital, and at 6, 12, and 24 months postburn. Participants were categorized as with or without moderate to severe sleep onset insomnia based on in-hospital BSI. The SF-36 bodily pain index (BP) was the primary outcome measure. We conducted linear mixed effects analyses to model the effects of discharge insomnia on longitudinal pain. The majority (>90%) of subjects reported at least moderate pain at discharge. On long-term follow-up, the sample demonstrated significant elevations in bodily pain relative to population norms. Persons who reported moderate to severe sleep onset difficulties at discharge (44%) reported more pain at all time points (p<0.05). After controlling for premorbid health status, discharge pain severity, total burn surface area (TBSA), TBSA grafted, discharge mental health status, and demographics (age & sex), sleep onset difficulty predicted elevation in bodily pain severity over the 2-year follow up (F1,277 = 6.67, p=0.01). The findings document high rates of chronic pain after serious burn injury and indicate that sleep onset insomnia at discharge is associated with poorer pain–related outcomes. Future work is needed to ascertain whether aggressive treatment of insomnia and pain during acute painful injury can prevent or minimize chronic pain conditions.