Approximately 65% of people with chronic back pain suffer from some type of sleep disorder, and inadequate sleep can exacerbate back pain, creating a vicious cycle of chronic pain and insomnia. However, there are a few simple modifications that you can make to your sleeping regimen to improve both your quality of sleep and pain levels.
Insomnia & Non-Restorative Sleep
Chronic back pain and sleeping problems can affect each other in various ways. Trouble falling asleep, or insomnia, is the primary issue for those who suffer from back pain, as it can be difficult to find a pain-free position. Additionally, when the sleeping environment is quieted and distractions fade away, the brain tends to focus on and amplify pain perception.
Once back pain patients manage to fall asleep, they may also suffer from non-restorative sleep (NRS), issues sleeping through the night and/or waking up feeling tired even after sufficient or prolonged periods of rest. NRS is often a result of micro-arousals, a change in the sleep state to a lighter stage of sleep trigged by stress or pain, causing diminished energy, depressed mood, fatigue and pain during the day.
Sleeping Position
One of the simplest and most effective ways to combat insomnia and NRS is to be sure that your sleeping position does not put added pressure onto your back. If possible, do not sleep on your stomach, as this position goes against the natural curve of the spine, causing the back to cave in and place stress on the entire body. Sleeping on your side with your knees aligned is a smart alternative but can lead to back and hip pain if the legs slide forward during the night, rotating the spine. The healthiest sleeping position for back and body is on your back, because it allows the head, neck, and spine to maintain a neutral position, and does not force extra curves into the back. A pillow under the knees can also help with support.
Add a Pillow
No matter your natural sleeping position, adding a pillow can balance pressure on the body while lying down. If you sleep on your side, place a pillow between your knees to help keep your hips level and the spine straight. If you tend to sleep on your stomach, put a pillow under your lower abdomen and pelvis to ease back strain. If you are a side sleeper, draw your legs up towards your chest and sleep with the pillow between your knees to alleviate pressure on your hips and lower back. Only draw up your legs slightly, as tucking the legs up too close to the chest will result in an over-rounding of the lower back. If you sleep on your back, put a pillow under your knees.
Mattress Choice
Without the right support, your mattress can cause or worsen back pain. If your mattress is too firm, it cannot contour enough to the body and support the lower back, resulting in additional pressure on the spine. An overly soft mattress, on the other hand, lets the lower back sink in, throwing the spine out of alignment and placing stress on the muscles, ligaments and spinal joints. Studies have shown that a mattress of medium firmness is the best choice, as it provides ample support for the back, while distributing pressure points on the body.
If you tend to toss and turn, a memory foam mattress might be the right choice for you. The mattress’s uniquely dense material helps prevent back pain and discomfort, by conforming to the body, keeping the spine in alignment and promoting good sleeping posture throughout the night.
Sleep Hygiene
Maintaining proper sleep hygiene, habits and practices that are conducive to sleeping well on a regular basis, helps promote better sleep and overall health. To start, stick to a regular wake and sleep pattern, by going to sleep and waking up at the same time every day of the week. It is also good practice to reserve your bed for only sleep, as your mind will begin to associate your bed with wakefulness if you use it as a center for activity, whether reading or watching TV. Additional sleep hygiene tips include avoiding napping during the day, establishing relaxing bedtime rituals like stretching or meditating, and making sure there is adequate exposure to natural light in your bedroom.
Do you have trouble falling or staying asleep due to back pain? What sleeping habits and routines do you practice to help combat these issues? Tell us about your experiences on Facebook.