Give Your Back Better Rest With These Sleep Tips

Although specialists used to recommend an extra firm mattress as the ideal choice for proper back support, that guidance is now considered outdated, according to Neel Anand, M.D., director of spine trauma at Cedars-Sinai Spine Center in Los Angeles. “In fact, new studies have shown a too-hard mattress may actually create more pain because there isn’t enough ‘give’ near pressure points like your hips and shoulders,” he says. Instead, he suggests looking for a mattress that supports the natural curve of the spine when lying flat and on your side, which tends to be a medium-firmness choice.

There are many companies selling affordable mattresses online, but Dr. Anand recommends trying out options in a store, and not to rush the decision. “You’ll want to lie on each mattress for a minimum of 15 minutes to get a true idea of what it will be like to sleep on it all night long,” he says. “If you’re shopping for you and a partner, you should go together to make sure you’re not sinking too much into the mattress when you’re both on it, which is a major sign that it's not supportive enough.”

Although an adjustable bed may be a strong choice for you, they can be much more expensive than a standard mattress, says Dr. Anand. Before making the investment, he suggests playing around with extra pillows. For example, put a pillow under your knees if you sleep on your back, or between your knees if you sleep on your side. These positions will help take pressure off your lower back, he says. It may take time to find the right pillow combination that can assist with getting you into the correct position, but Dr. Anand says it’s worth the effort.

Cervical contour pillows are very effective for most people with AS, says Dr. Anand, because it allows your neck to be in a better position, which helps your lower back. He says foam contour pillows are also a top choice. “Keep in mind that if you have a firmer mattress, you’ll need a thicker pillow because there is less cushion for your shoulder to sink into, so there’s greater space between your mattress and your head,” he says. With a memory foam mattress, you’ll need the opposite—a thinner pillow that compensates for your shoulder sinking into the bed.

When you have AS, it’s particularly important to have a night routine. “It's best to establish a bedtime habit, such as ensuring your room is quiet and dark, and minimizing screen time as you wind down,” says Thomas McNally, M.D., medical director of the Spine Institute at the Chicago Center for Orthopedics at Weiss Memorial Hospital in Chicago. Much like pillow adjustment, it may take time to play around with different options and see what works best for you. But when you find a routine that clicks, make that an essential part of your sleep.

“A part of any bedtime routine should be to relax your muscles before bed, which will reduce tightness in the back,” says Tammy Penhollow, D.O., owner of Precision Regenerative Medicine in Phoenix, AZ. Pain can be amplified when your body is inflamed, and since AS is an inflammatory condition,stretchingbefore bed helps lower the inflammation response, she says. Rolling your shoulders to the front and back or doing child’s pose can help. She also suggests a gentle movement practice like yoga or Tai Chi that can help calm the nervous system and ease you into sleeping faster.

What you do throughout the day can have a major impact on how well you sleep, according to James Lin, M.D., a spine surgeon and assistant professor of orthopedic surgery at the Icahn School of Medicine at Mount Sinai in New York City. “Often, back pain can be alleviated through lifestyle changes such as starting a regular moderate-intensity exercise routine,” he says. That might include 20 minutes of daily walking or biking, or a low-impact gym class.

Another daytime tweak that can bring restful sleep is making sure you get outside, says Vernon Williams, M.D., founding director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “This has to do with your brain’s sleep-wake ‘clock’ and is a frequently overlooked factor in getting better sleep,” he notes. TheCenters for Disease Control and Preventionsuggests that bright morning light is particularly powerful, and can not only help with sleep, but also boosts your alertness level during the day.

Finding ways to adjust to sleeping with minor AS pain or discomfort is common, but if your pain is severe enough to keep you from dozing off even with these suggestions, or if it’s associated with any neurologic symptoms like weakness or sciatica, Dr. Lin suggests making an appointment with your doctor. There may also be a chance that you need a medication change, since you shouldn't be experiencing sudden pain flares during the night, he adds. Your doctor can also help with other resources, such as physical therapy, a sleep study, stress reduction, and other strategies.