How to Sleep With Back Pain

Tips for Turning Your Torture Chamber Into an Oasis of Rest

How to Sleep With Back PainIf you live with chronic lower back pain or neck pain, sleep has probably become a challenge for you. Even before I developed fibromyalgia, I had chronic upper back and SI joint pain, which caused countless sleepless nights.

By the time I was finally diagnosed, I had come to see my bedroom as a torture chamber! This article focuses on tips for sleeping better, based on my many trial and error experiences, divided into two sections: how to best support your sleep posture (using pillows and mattress toppers) and how to manage your sleep environment (by focusing on temperature, light and noise).

I have researched and tried most of these strategies, and my hope is you find some ideas here to transform your torture chamber into an oasis of rest. Sleeping as well as you can is important for your overall health, as well as for managing your chronic pain.

One final note — if self-care strategies are not enough, it’s important to talk to your healthcare professional about getting additional help.

Body Support: Pillows, Mattresses, and Mattress Toppers

If you live with chronic neck or back pain, the days of sleeping on any old mattress, with any old pillow, in any position, are probably over (or they should be!)

Neck Pillow

Without a supportive neck pillow I develop serious neck pain and migraines. Sometimes called orthopedic or ergonomic neck pillows, they are often designed in a contoured wave-like form, and support the natural alignment of the head, neck and spine.

If you sleep on your side, there are specially designed contour pillows, and this will be advertised in the description. Materials like memory foam, latex or bamboo fiber help provide consistent, durable support.

Orthopedic neck pillows are more costly than regular pillows, starting at about $30. In my experience, though, buying one is totally worth it! Pillows should be replaced every 1-2 years.

Additional Pillows for Body Support

Many back pain experts recommend using pillows to support your posture while you sleep. I have to sleep on my back at all times, or else my spine revolts!

In this position, most experts recommend stacking one to three pillows under your knees to relieve pressure on your lower back. Some also recommend placing a small pillow under the low back (personally I find this uncomfortable, but we are all unique).

If you sleep on your side, bend your knees and put a firm pillow in between to keep your spine aligned. Sleeping on your stomach is not recommended for back pain, but if you can only fall asleep this way, put a small pillow under your hips.

Mattress and Mattress Toppers

My parents always swore that a firm mattress cured back pain. Personally, a firm mattress triggers my SI joint pain!

Whether to use a soft or firm mattress is a decision best made with your physical therapist or chiropractor, and depends on your personal situation and preferences. I use a memory foam mattress cover so my body is supported better than my mattress alone can provide.

Another mattress topper option is the CuddleEwe, which uses specialty wool, and is designed to relieve pressure on your body contact points when lying down (ex. shoulders and hips) by diffusing weight.

Alternatively, there is the N:rem mattress topper, which lets you rearrange panels of soft, medium or firm support where you need them, like puzzle pieces. I have not tried these last two products but have read positive reviews written by chronic pain bloggers.

Next page: how to sleep with back pain — temperature, light, and noise.

Managing Your Sleep Environment: Temperature, Light and Noise

For some people, pain itself keeps them awake. For others, with chronic illnesses like fibromyalgia, unrefreshing sleep is part of their diagnosis — research suggests that stages of deep sleep are frequently interrupted.

It is important to minimize disturbances by making sure your sleep environment is conducive to good sleep. I have become really sensitive to light and noise since the onset of my fibromyalgia, and with all the accessories I use, like a sleeping mask, ear plugs, or head phones, I joke that I am the ‘sleep cyborg’!


Research shows that many people sleep better in cooler temperatures, usually between 60-67 F. It is helpful to have breathable bed linens and blankets.

Good materials include natural fabrics that wick moisture away, like cotton, bamboo or linen. A higher thread count actually equals less breathable sheets, so if you tend to overheat, this could be an important factor.


I sleep best in absolute darkness, and I’m not alone. Experts say you produce optimal levels of the sleep hormone melatonin in darkness.

This means turning off all electronics, facing your backlit alarm clock away from you, and using heavy window coverings to block out streetlights. I love my blackout blind from Ikea, which blocks all light from coming in through my window.

I also use a sleep mask for those stray beams that come in under the door or through the crack between the blind and the window.


If your partner snores, or the dog next-door barks all night, or the birds start chirping at an ungodly hour, you may want to consider taking steps to prevent these sounds from disrupting your sleep. Earplugs are the first line of defense for most people.

I use silicone earplugs that cover your ear canal instead of being inserted — I find them more effective and I also worry about ear problems from regular plugs. Alternatively, you can play white noise.

White noise works by reducing the difference between background sounds and a “peak” sound, like a door slamming, giving you a better chance to sleep through it undisturbed. White noise includes the sound of static, a fan, or heavy rainfall.

There are many apps that play types of white noise though your phone or tablet using regular speakers connected to your phone or you can also buy ‘sleep phones’ — headband headphones that can be comfortably worn while sleeping.

Alternatively, you can buy a sound machine that plays pre-programmed white noise. I regularly play white noise rain sounds and it helps me sleep, especially through the early morning hours.


University of Utah Health Care (Good Sleeping Posture Helps Your Back)

NFMCPA (Sleep Disorders)

Huffington Post (Buying Guide: The Best Sheets To Keep You Cool This Summer)

National Sleep Foundation (Melatonin and Sleep)

National Sleep Foundation (Hear)

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Katarina ZulakKatarina Zulak

Katarina Zulak is an ePatient blogger and health writer. Six years ago she was diagnosed with fibromyalgia. On her blog, she writes about learning to be skillfully well, even when living with a chronic condition. Katarina lives in Toronto, Canada with her husband and their cat Lily.

Nov 21, 2016
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