How to Sleep Better with Lower Back Pain

According to the World Health Organization¹ (WHO), low back pain affects over 600 million people worldwide, and the number of sufferers is expected to significantly increase over future decades. A 2022 survey² found that about 28% of American adults experience chronic pain in their lower back, while the American Association of Neurological Surgeons³ reports that up to 85% of Americans experience back pain at some point throughout their lives. Back pain is also a leading cause of disability⁴ in the United States and at the global level⁵.

Various factors cause and contribute to low back pain⁶, including injury, illness, weight and spine misalignment. Pain impacts people's lives⁷ in various ways, including an inability to perform basic activities of daily living⁸, time lost from work and missed social opportunities. It can also affect sexual function and mental health⁹. Various studies also connect lower back pain and poor sleep¹⁰. This article looks at how pain in the back impacts sleep quality and vice versa¹¹ — how poor sleep can exacerbate back issues and pain. It also contains tips for sleeping better when experiencing low back pain.

Lower Back Pain and Sleep

Quality sleep is vital¹² for overall health and well-being. It's critical for physical¹³ and mental¹⁴ wellness, an optimum immune system, cognitive function¹⁵, hormone regulation, daytime activity and more. Moreover, healthy sleep is linked to longevity¹⁶.

A 2014 study found that poor sleep increases lower back pain¹⁷ the day after, while research from 2015 indicates that back pain negatively affects sleep duration and quality¹⁸. Research in 2022 reaffirmed links between lower back pain and sleep disturbances¹⁹. Individuals can become trapped in a cycle, whereby pain impacts sleep and sleep deprivation increases pain intensity — never getting enough sleep²⁰ — with the resulting effects impeding overall health and quality of life. Moreover, poor quality sleep may in itself be a causative factor for lower back pain²¹.

Essentially, low back pain can prevent people from falling asleep, wake them from sleep, stop them from entering a deep stage of sleep, cause restfulness, lead to distress and impact daytime activities. Likewise, inadequate or insufficient sleep can worsen or cause back pain, alongside harming overall wellness.

Tips for Sleeping Better with Back Pain

Fortunately, it's possible to manage pain and improve sleep quality. These tips may help:

Consult a Physician

If individuals don't know why they have lower back pain, they should consult a doctor. There are treatments²² that can lessen or resolve pain, including medications, therapies and surgical interventions. Sometimes, lifestyle changes can help. Physicians may also recommend using at-home ice or heat treatments and doing specific exercises²³. On occasion, nocturnal back pain²⁴ indicates a more serious issue.

Similarly, doctors may check whether individuals have undiagnosed sleep disorders²⁵ that exacerbate lower back conditions. For example, sleep therapy²⁶ may improve sleep and related pain.

Change Positions

Sleep positions²⁷ can greatly impact pain severity, comfort and sleep quality. Generally, professionals believe the best position for lower back pain is flat on the back²⁸ with knees elevated by a bolster or pillow. However, that posture can worsen snoring and may not be comfortable. Other positions to try include:

• Side sleeping with a pillow between the knees - The pillow helps maintain the natural alignment of the pelvis and spine. Another pillow under the waist can add extra support, while one against your chest can prevent rolling.
• Fetal position - Keeping legs curled toward the abdomen may open up the joints and bring relief, especially in the case of a herniated disc²⁹.
• Supported stomach sleeping - Lying unsupported on the stomach can put a lot of pressure on the neck and spine. However, those who find this position preferable may find it comfortable if they put a pillow under the stomach and hips.

Additionally, individuals may consider an adjustable bed to find the optimum pain-free sleeping position.

Renew Mattresses and Pillows

Mattresses and pillows can significantly affect pain, sleep quality and comfort. A new mattress³⁰ with plenty of lumbar support can ease pain and promote sleep. Experts typically recommend medium to firm mattresses³¹, although individuals should choose the one that feels best for them while supporting their body and allowing neutral alignment when lying down. Flatter pillows³² keep the spine aligned, and people may also use pillows to support their sleeping position. Users of sleep equipment may benefit from specially shaped pillows, too.

Establishing a good sleep routine, stretching before bed, changing eating and drinking habits and being careful to avoid jolting before and while in bed are some ways to relieve lower back pain and promote sleep. Others include improving posture, taking time to relax before bedtime, trying aromatherapy³³ and using painkillers.

References

1. World Health Organization – Low back pain
2. Statista – Back pain in the U.S. – Statistics & Facts
3. American Association of Neurological Surgeons – Low Back Pain
4. National Center for Complementary and Integrative Health – U.S. National Survey Identifies Associations Between Chronic Severe Back Pain and Disability
5. Institute for Health Metrics and Evaluation – The Lancet: New study shows low back pain is the leading cause of disability around the world
6. Cleveland Clinic – Lower Back Pain
7. International Journal of Nursing Studies Advances – Disrupted everyday life in the trajectory of low back pain: A longitudinal qualitative study of the cross-sectorial pathways of individuals with low back pain over time
8. WebMD – What Are Activities of Daily Living (ADLs)?
9. National Library of Medicine – Association between low back pain and various everyday performances
10. MedicalNewsToday – How are poor sleep and lower back pain related?
11. National Library of Medicine – The bidirectional relationship between pain intensity and sleep disturbance/quality in patients with low back pain
12. National Heart, Lung, and Blood Institute – Why Is Sleep Important?
13. Psychology Today – Sleep and Physical Health
14. National Library of Medicine - Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
15. National Library of Medicine – The consequences of sleep deprivation on cognitive performance
16. SoClean – New Research: Sleep Well to Live Longer
17. National Library of Medicine – Poor sleep quality is strongly associated with subsequent pain intensity in patients with acute low back pain
18. National Library of Medicine – Knee Pain and Low Back Pain Additively Disturb Sleep in the General Population: A Cross-Sectional Analysis of the Nagahama Study
19. BMC Musculoskeletal Disorders – Low back pain is associated with sleep disturbance: a 3-year longitudinal study after the Great East Japan Earthquake
20. SoClean – How Much Sleep Do You Need?
21. Nature – The effect of long-term poor sleep quality on risk of back-related disability and the modifying role of physical activity
22. Johns Hopkins Medicine – 7 Ways to Treat Chronic Back Pain Without Surgery
23. Mayo Clinic – Back exercises in 15 minutes a day
24. WebMD – Nighttime Back Pain
25. SoClean – Confronting Sleep Disorders: Identifying Signs and Pursuing Effective Treatment
26. SoClean – Our Top Hacks for Improving Your Sleep Therapy Experience
27. SoClean – A Guide to Healthy Sleep Positions
28. MedicalNewsToday – How should you sleep if you have lower back pain?
29. Mayo Clinic – Herniated disc
30. Health – The 10 Best Mattresses for Back Pain to Help You Wake Up Pain-Free, Tested by Our Editors
31. Journal of Orthopaedics and Traumatology - What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature
32. SoClean – How to Choose the Perfect Pillow