How to sleep with lower back pain

Whether your back pain is temporary from an injury or long term due to an underlying chronic condition, living with lower back pain can be uncomfortable, especially as it can affect your sleep.

Certain medications can help ease lower back pain and make sleeping easier. Other methods may also make it easier to get some sleep, such as considering how your sleeping position affects your back.

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What’s the link between back pain and sleep?

When you’re in pain, it’s natural that it may have some effect on your sleep. When you’re trying to sleep, there is nothing to distract you from your pain, so it may feel worse and stop you from falling and staying asleep.

Some 2022 research indicates that pain may actually worsen at night. The study suggests that pain may follow a circadian rhythm, which is the body’s internal clock regulating the sleep-wake cycle. This means pain might be higher at certain times of the day, such as when you’re trying to sleep.

And according to some 2019 research, the link between sleep disturbances and chronic pain may work both ways. This means that chronic pain may worsen sleep, but disturbed sleep may also worsen your pain.

A 2018 paper suggests that insomnia can worsen pain, but a particularly restful night may lessen pain the following day, although this effect is smaller.

This implies that improving your sleep may improve your back pain, and improving your pain may improve your sleep quality.

Strategies for better sleep

If your back pain is affecting your sleep, you’ll likely be keen to find ways to improve your sleep. Certain strategies can make getting to sleep easier, whether or not you experience chronic pain. These include:

• Practicing good sleep hygiene: Creating a healthy sleep environment can help with your sleep quality. This can include having a dark, cool, quiet sleep environment at bedtime.
• Trying relaxation techniques: Relaxing before bed can also help you get to sleep. You could try taking a warm shower, performing yoga or stretching, and doing breathing exercises.
• Avoiding screens before bed: Scrolling on your phone at bedtime may make it harder to fall asleep. Consider reading a physical book before bed instead.

If you have lower back pain, it’s also important to consider what sleeping position works best for you. This could be different for everyone, and what works best for one person may not be the best position for you.

A 2024 study looked into the effect of sleeping position on lower back pain and found that lying prone — lying flat on your stomach — was associated with worsened pain in many participants. The researchers also found that lying on your side was the general preference among people with chronic lower back pain.

You might also want to consider whether your mattress is affecting your pain. Some people benefit from a firmer mattress, while others might prefer a softer one.

A 2022 study looked into the effects of mattress shape on lower back pain. The researchers provided participants with a mattress designed to reduce spinal curvature when sleeping on their sides. This mattress was associated with reduced pain and higher comfort.

Medications for lower back pain

If you experience chronic lower back pain, you can speak with a healthcare professional for diagnosis and treatment. Your back pain may be due to various underlying causes, and managing these conditions can help ease your pain and improve your sleep. Common causes include:

• muscle strains
• herniated discs
• osteoarthritis
• lumbar spinal stenosis

To help with sleep, doctors might recommend over-the-counter (OTC) pain relievers like ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol). They may also prescribe muscle relaxers like metaxalone and cyclobenzaprine (Amrix) to help ease pain.

Doctors might also prescribe sedatives to help you sleep if you’re experiencing insomnia related to your back pain. These include:

• eszopiclone (Lunesta)
• zaleplon (Sonata)
• zolpidem (Ambien)

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Summary

Lower back pain can seriously affect your quality of life, including disrupting your sleep. What’s more, disrupted sleep may worsen pain when you’re awake.

There are many strategies to help improve your sleep when you’re living with back pain. You can consider your sleeping position and try to find one that helps ease your pain. You may also want to change your mattress to one that helps reduce the curvature of your spine.

You can also implement good sleep hygiene practices and aim to relax before bedtime.

Treating the cause of your lower back pain may also improve your symptoms and your sleep. You can try OTC pain relievers to help manage pain, and doctors might prescribe muscle relaxers. Sedative medications can also help with insomnia related to back pain.

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