3 Little-Known Tips for Sleeping with Sciatica

Getting a sufficient amount of restful, restorative sleep is an essential component of an effective sciatica treatment plan. However, if your pain is severe, it can be a challenge to find a comfortable position and to fall asleep and/or to stay asleep through the night.

There is an abundance of information available recommending various sleep positions or products, but much of this is anecdotal. Here are helpful tips, backed by medical research, to help you find relief and regain control of your sleep schedule.

1. Place a pillow between your legs

Limited research suggests that sleeping on your side may be protective against spinal pain.¹Gordon S, Grimmer K, Trott P. Sleep Position, Age, Gender, Sleep Quality and Waking Cervico-Thoracic Symptoms. Internet Journal of Allied Health Sciences and Practice. 2007;5(1). Available from: https://nsuworks.nova.edu/ijahsp/vol5/iss1/6/ If you’re a side sleeper, placing a pillow between your thighs or legs may help reduce pressure on the spine.

Watch Pillow Tips for Sciatica Video

To follow this technique, lie on your side with your knees slightly bent and place a regular bed pillow, a body pillow, or a wedge pillow between your thighs/knees.

See What to Look for in a Pillow if You Have Sciatica

2. Elevate your knees

Sleeping on your back or stomach may increase the risk of lower back pain,²Abanobi O, Ayeni G, Ezeugwu C, Ayeni O. Risk-Disposing Habits of Lowback Pain amongst Welders and Panel Beaters in Owerri, South-East Nigeria. Indian Journal of Public Health Research & Development. 2015;6:187. doi:10.5958/0976-5506.2015.00164.3 possibly because such positions increase the amount of pressure on the small joints in the back of the spine. If you’re a habitual back sleeper, try sleeping with your knees slightly elevated.

• Lie flat on your back and keep your buttocks and heels in contact with the bed.
• Bend your knees slightly towards the ceiling.
• Slide a pillow under your knees. Slowly add additional pillows until you find a comfortable knee and lower back position.

Pillows of different shapes, density, and contours may be used for elevating your knees. A few examples include regular bed pillows, cylindrical pillows, or wedge pillows. You may also choose between memory foam and down pillows depending on the level of firmness preferred.

See Pillow Types to Consider

3. Try a medium-firm mattress

Research suggests that using a medium-firm mattress may help reduce lower back pain.³Ancuelle V, Zamudio R, Mendiola A, et al. Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders. Sleep Sci. 2015;8(3):115–120. doi:10.1016/j.slsci.2015.08.004^,4Radwan A, Fess P, James D, et al. Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep Health. 2015;1(4):257-267. doi:10.1016/j.sleh.2015.08.001^,5Jacobson BH, Boolani A, Smith DB. Changes in back pain, sleep quality, and perceived stress after introduction of new bedding systems. Journal of Chiropractic Medicine. 2009;8(1):1-8. doi:10.1016/j.jcm.2008.09.002 A mattress should keep your spine well-aligned over the course of the night. For side sleepers, a mattress that is too firm does not allow the shoulders to sink down sufficiently, and a mattress that is too soft allows the heavier pelvis to sag excessively – both of these scenarios result in a poorly aligned spine and potentially more pain and stiffness.⁶Leilnahari K, Fatouraee N, Khodalotfi M, Sadeghein MA, Amin Kashani Y. Spine alignment in men during lateral sleep position: experimental study and modeling. BioMedical Engineering OnLine. 2011;10(1):103. doi:10.1186/1475-925X-10-103

Consider trying out a new mattress that comes with an extended money-back guarantee so that you have time to give it a test drive.

See Mattresses and Sleep Positions for Each Back Pain Diagnosis

Self-adjustable mattress

There is evidence that beds that allow you to actively control the firmness (custom inflatable/self-adjustable) may improve spinal alignment, sleep quality, and back pain⁷Monsein M, Corbin TP, Culliton PD, Merz D, Schuck EA. Short-term outcomes of chronic back pain patients on an airbed vs innerspring mattresses. MedGenMed. 2000;2(3):E36. PMID: 11104482^,8Price P, Rees-Mathews S, Tebble N, Camilleri J. The use of a new overlay mattress in patients with chronic pain: impact on sleep and self-reported pain. Clin Rehabil. 2003;17(5):488-492. doi:10.1191/0269215503cr640oa – this way you don’t have to make a final decision on firmness, and you can even adjust the mattress based on your current sleep position. Some adjustable mattresses have multiple zones that provide customers with even more control.⁹Verhaert V, Haex B, De Wilde T, et al. Ergonomics in bed design: the effect of spinal alignment on sleep parameters. Ergonomics. 2011;54(2):169-178. doi:10.1080/00140139.2010.538725

See Considerations Before Buying an Adjustable Bed

Finding the right sleep position is a process of trial and error; no single sleep position works for everyone. Keep experimenting and you may find that a different position minimizes your sciatic pain and allows you to sleep through the night.

Learn more:

Why Your Leg Pain Feels Worse When Lying Down

5 Tips to Relieve Sciatica Pain