Do you know how to sleep with sciatica? Which is the best sleep position for sciatica? Will your sleep position positively or negatively impact your pain? How does one select a sleep position anyway? After all, you will be unconscious, so how do you stay in place?
These are all common questions that we receive here on The Cure Back Pain Network and these queries deserve expert attention. Without quality sleep, any patient will suffer more, since they will be deprived of their rest. Resulting consequences will affect the mind, body and spirit equally, creating physical, cognitive and emotional disturbances.
We have already written quite a lot about the relationship between sleeping and back pain, as well as specific advice for sleeping with sciatica. In this discussion, we will specifically detail the worst and best sleep position for sciatica based on many years of clinical experience, as well as the latest research evidence.
How to Sleep with Sciatica Possibilities
When discussing sleep positions, one can basically account for all possibilities in short order. A patient can sleep on their back, on their side, on their stomach or sitting up. Each of these positions will affect pain differently and some are certainly more advantageous than others. Therefore, let’s look at a basic evaluation of the benefits and drawbacks of each possible sleep position in terms of how it may influence sciatica symptoms:
Back sleeping in the most common position. Sleeping on one’s back can be performed with the legs straight out or with one or both bent upwards or outwards to various degrees. Back sleeping is an easy position to maintain and is cited as being the most comfortable by many people. However, back sleeping can incite snoring and therefore contribute to sleep apnea. Back sleeping can put direct pressure on the spine, sciatic nerve and muscular tissues of the back and buttocks, often escalating sciatica symptoms. Back sleeping can also put lots of pressure on the cervical spine, especially when a thick pillow is utilized.
Sleeping on one’s side is the second most popular posture for sleep and the one which places the spine in its most neutral positioning. Side sleeping can also be performed in different ways, with variations in one or both legs being straightened or bent upwards, as well as variable positioning of the arms. Most people tend to prefer the fetal position where the knees are both bent upwards and the arms casually laid directly in front of the face and body. Side sleeping removes the majority of pressure from the sciatic nerve.
Stomach sleeping is far less common and for good reason. Stomach sleeping puts major strain on the cervical spine, if any pillow at all is used. Stomach sleeping can interfere with breathing, incite snoring and cause neurological dysfunction during sleep. Stomach sleeping can also interfere with digestion. However, stomach sleeping does remove virtually all pressure from the sciatic nerve.
Sleeping sitting up is often a coping strategy for patients who can not find a more comfortable traditional position to rest or for people who tend to fall asleep in front of the television. Sitting can removes some pressure from parts of the sciatic nerve, but generally focuses force on other areas, especially those in the buttocks and upper dorsal thighs. Allowing the head to hang downward or backward while sleeping sitting upright is highly detrimental to spinal health and can cause major problems, such as vertebral subluxation, pinched nerves, muscular strain, RSI and even vertebral degeneration over time.
Maintaining the Optimal Sleep Position
Staying put in one’s sleep can be a challenge, especially for restless individuals who tend to roll about often. However, there are strategies that can be very effective for keeping you still while sleeping, as well as providing extra anatomical support and comfort for your body while at rest:
Extra pillows under the head are never a good idea, as they strain the neck and create unnatural anatomical position of the cervical spine. However, extra pillows are ideal for preventing rolling in one’s sleep and can be placed strategically to keep a position static all night long. Generally, pillows can be placed like wedges anywhere on the body that might prevent rolling or excessive motion. Extra pillows can also provide added comfort and insulate anatomical structures (legs and arms) from each other to prevent pressure and skin irritation.
The right firmness on the sleep surface can also prevent excessive motion during sleep. An overly firm surface encourages movement while actually asleep, while an overly soft surface can lead to poor quality sleep and restlessness.
Having an understanding partner can also help, as they can help to adjust your pillows if you begin to move about and disturb them during sleep.
How to Sleep with Sciatica Advice
We tend to recommend the fetal position as the best sleep position for sciatica and for all people, for that matter. Side sleeping is the optimal posture for healthy sleep and also reduces most of the complications caused by horizontal positioning in sciatica sufferers. To truly maximize the benefits of fetal sleeping, we recommend the following suggestions:
It is a good idea to place pillows around yourself, front and back, when side sleeping. Wedge or throw pillows work well for this purpose, as can a full body pillow front and/or back. Placing a small pillow in between the knees will reduce pressure and spare the joints some possible pain. Likewise, placing a pillow under the top arm will help support the limb and align the shoulder anatomically to reduce strain.
Use a single pillow of the head and make sure that it is the right thickness to support the head without allowing it to drop too far or be pushed upwards due to being too thin or too thick respectively.
Do not overly tuck the chin (excessive neck flexion), as this can also cause cervical strain over time. Allow the head to remain straight and fully supported by the pillow.
We have written much about the effects of pain on sleep and provide a variety of tips on improving the quality and quantity of sleep, despite pain, in our other articles on back pain and sleep. We also provide direct guidance on the best sleep position for sciatica in our proprietary pain relief program and focus on enhancing sleep through both physical and psychoemotional practices that are proven to work wonders for most chronic pain sufferers.