Man sitting on bed with hands on lower back and painful expression.

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How to Sleep With Lower Back Pain: A Helpful Guide

· Article

How to Sleep With Lower Back Pain: A Helpful Guide

Where Does Lower Back Pain Come From?

Lower back pain often stems from work-related tasks. Lifting heavy boxes of printing paper, overexertion during construction work or long hours sitting at a desk job — often with bad posture — are all common culprits.

“I see a lot of people with chronic back pain who are sedentary in their job all day long,” says sleep expert Dr. Robert S. Rosenberg, a diplomat of the American Board of Sleep Medicine, who is board-certified in sleep medicine. “They don’t get up. They don’t stand.”

This is a problem because sitting puts more pressure on your lower back than standing, which might result in pain.

Carrying a heavy purse on the same arm at all times, lifting your kids or playing with them too roughly may also cause lower back pain. Even an otherwise good-for-you workout can strain your lower back if you are overdoing it, not lifting correctly, or forgetting to stretch or rest.

“I see people who go to the gym and work out, and they do crunches, but they’re not doing them properly and they end up with back pain from that, or from weightlifting to excessive amounts,” Dr. Rosenberg notes.

Another potential cause of lower back pain is spine problems like slipped discs, spinal stenosis — a narrowing of the spaces within the spine that may put pressure on the nerves and spinal cord — and scoliosis, which causes the spine to curve to the left or right. According to the National Institute of Neurological Disorders and Stroke, other health conditions predisposing people to lower back pain include arthritis, the bone disease osteoporosis, an inflammation of the vertebrae known as spondylitis, and endometriosis, in which the tissue that normally lines the uterus grows outside of it instead.

Implications and Impact of Poor Sleep

Back pain can make it difficult to get a good night’s sleep, and insufficient slumber may in turn exacerbate the painful symptoms, creating a vicious cycle.

“We know that about 40 percent of patients with chronic back pain complain of an inability to either fall asleep or remain sleep,” Dr. Rosenberg states.

Some people with the condition wake up multiple times at night without realizing it, which ruins their sleep, he says. Not getting enough sleep may then trigger inflammation, which further contributes to back pain. Multiple studies, including one in the journal Sleep Medicine, also suggest that sleep deprivation increases sensitivity to pain.

The consequences of inadequate sleep go beyond back pain itself, potentially affecting other aspects of a person’s health, both physical and mental. Obesity, diabetes, cardiovascular disease and hypertension have been linked to sleep loss, according to an e-book, Sleep Disorders and Sleep Deprivation, by the Institute of Medicine of the National Academies. Lack of sleep may also lead to irritability and more serious psychological conditions such as anxiety and depression. Dr. Rosenberg notes that many studies have shown that insomnia precedes depression.

“I see a lot of patients with low back pain who see me for insomnia, and a significant amount of them are also on antidepressants and frequently they tell me the insomnia and the back pain preceded the depression, and it was only after a year or two of chronic pain and lack of sleep that they developed the depression and, in some cases, severe anxiety disorders,” he shares.

People who don’t get enough sleep are more likely to be tired during the day, which has disastrous consequences for their productivity. In fact, the American Academy of Sleep Medicine estimates that the average worker in the United States loses 11.3 days or $2,280 in productivity to insomnia per year. And sleep-deprived individuals were more likely to commit errors while performing memory-dependent tasks than those who had a good night’s sleep, according to a study in the Journal of Experimental Psychology: General.

Best Sleep Positions for Lower Back Pain

If you have lower back pain, you should sleep in a way that puts your back, spine, pelvis and hips in a neutral position, recommends Dr. Rosenberg. Using pillows may help with that.

“So, if you’re a back sleeper, it’s best to put a pillow under your legs. If you’re a side sleeper, it’s best to put the pillow between your legs,” he says. Dr. Rosenberg advises against stomach sleeping, but if you absolutely cannot force yourself to sleep in any other position, putting a pillow under your abdomen may help to keep the spine in a neutral position.

Exercise and Stretching

An exercise plan designed to support the type of injury you have may allow you to cope with lower back pain more effectively for better sleep. A regular regimen combining strength, flexibility and aerobic fitness training can be beneficial for people with the condition, according to a review of previous research published in 2016 in the journal Healthcare.

Below are also some simple exercises and stretches you may consider, according to WebMd. As always, consult a doctor before trying any new workout regime to make sure it’s appropriate for your specific back problem (this is especially important if you have any physical limitations).

Knee to Chest

Lie on your back while keeping your knees bent and feet flat on the floor. Then bring a knee to your chest, and, keeping your lower back in contact with the floor, hold the position for between 15 and 30 seconds.

Recommended number of reps: 2 to 4 for each leg

Wall Sits

Stand with your back against the wall. Lean back so that your back stays flat against the wall. Then slide down slowly and bend your knees. Press your lower back into the wall. Hold the position as you count to 10, then gradually slide back up.

Recommended reps: 8 to 12

Partial Crunches

Lie flat on your back and bend your knees. Put your hands behind your neck. Tighten your abs, and lift your shoulders off the floor while breathing out. Hold this position briefly and gradually lower back down. Focus on proper form by keeping your feet, tailbone and lower back on the mat throughout each rep. (Caveat: This exercise may not be a good idea if you have lower back pain that’s tied to a core issue, so consult a doctor first.)

Recommended number of reps: 8 to 12

Best Diet for Back Pain

Inflammation can trigger or negatively impact back pain, and diet can help fight inflammation.

According to Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health, “Many experimental studies have shown that components of foods or beverages may have anti-inflammatory effects.” An anti-inflammatory diet means eating mostly plants, as well as flax, chia seeds and fatty fish like salmon, sardines and tuna, according to the health website Everyday Health. In an interview with the publication, Dana Greene, a nutritionist in Brookline, Massachusetts, recommends consuming a variety of highly nutritious vegetables and fruits like beets, carrots, sweet potatoes, berries, grapes, pomegranate and watermelon.

Back pain sufferers should also make sure to get enough calcium to maintain bone health by consuming milk products such as yogurt, milk and cheese, and leafy green vegetables such as spinach or kale.

It is equally important to avoid foods that might trigger inflammation. This means no processed or fast foods, including white flour bread or pasta, white rice, sugar-laden soda, or fried foods and unhealthy snacks like chips and pastries, according to Everyday Health.

The reasons why the consumption of these foods leads to inflammation vary, but often involve blood sugar spikes. White flour, for example, lacks slow-digesting fiber and nutrients, which means the body breaks down white flour products very fast, Dr. Christopher Hollingsworth, an endovascular surgeon at NYC Surgical Associates, told Reader’s Digest. The faster breakdown causes a speedy increase in blood sugar, which can trigger insulin production, and result in inflammation.

Sleeping Environment

There are plenty of other factors you can control to sleep better. One of them is bedroom lighting. In a previous interview with Sleep Number, Clifford Starr, chief lighting designer consultant for Lighting by Gregory, recommended using dimmers to control the mood of your bedroom. He also said that people should use a few separate types of lighting including a main, ambient light that allows you to see everything well, and bedside lights for reading or watching TV.

Annoying sounds, like your partner’s snoring or your cat’s meowing, may also disrupt sleep. A white noise machine or earplugs will help. To banish street noise, cover your windows with heavy drapes or noise-blocking curtains.

Keep electronics out of the bedroom, as screen time has been linked to poor sleep, which may be tied to the blue light emitted by smartphones and iPads that suppresses the production of the sleep hormone melatonin.

Certain scents can help, especially lavender oil. A few drops in an oil diffuser around bedtime is one easy way of putting the findings into practice.

Bedroom temperature is another factor to keep in mind. Most folks find 70 degrees or so optimal. (Sleep Number’s DualTemp layer lets you adjust temperature.)

Keep your bedroom clean and uncluttered. Pamela Thacher, assistant professor of psychology at St. Lawrence University in New York, told US News & World Report that the more clutter you have, the higher your likelihood of having a sleep disorder.

A bedtime ritual can help you unwind and ready your body and mind for sleep. Consider reading a book or meditating before turning out the lights.

Mattress and Pillow

Selecting the right mattress is particularly important for people with lower back problems. Dr. Rosenberg recommends testing a variety of mattresses to find the right fit.

“The important thing is to really try the mattress out,” he says. “With Sleep Number beds, it’s best to try them at home because you need to adjust or play with the settings to find the proper firmness for you.” (All Sleep Number beds and the DualTemp layer are covered by our 100 night trial policy.)

If testing a mattress at home is not an option, then at least take some time to lie down on the mattress at the store, Dr. Rosenberg suggests.

In terms of firmness, Dr. Rosenberg recommends against very soft mattresses. “Moderate to firm seem to work better for most people,” he says.

The angle at which you sleep matters too. “People who have severely herniated, severe disk disease seem to sleep best when they can sleep 15 to 20 degrees upright,” Dr. Rosenberg adds. Sleep Number beds allow you to incline them to this angle, and (depending on the model) some beds can do this for one partner and not the other.

Finding the right pillow is also key.

“You want to find pillows that reduce the free space between your neck and the bed itself,” Dr. Rosenberg advises. “You want to fill up those spaces.” If the space separating your neck from the bed remains empty, it will cause stress and strain, he warns.

Next Steps

Not everyone can fix their back pain, but these simple tips may help. Sleep Number products may also help you find better back balance, and help you regain your sleep:

The Sleep Number 360® smart bed senses your movements and allows you to adjust firmness and support.

Pillow [ology]® allows you to create a perfect, comfy pillow.

DualTemp individual layercan be added to any mattress to adjust temperature on any side of the bed.

Like diet and exercise, quality sleep is essential for optimal health and performance. Because everyone’s sleep needs are different, Sleep Number 360® smart beds, with SleepIQ® technology inside, sense your movements and automatically adjust firmness, comfort and support to keep you both sleeping comfortably. Find your Sleep Number® setting for your best possible night’s sleep.

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