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Sciatica and Sleep: Understanding the Reciprocal Relationship

If you’ve ever lived with chronic pain, then you know it can impact all areas of your life. It may even make it difficult for you to sleep at night. That’s certainly the case for those living with sciatica, which can cause acute pain in the back, hips, buttocks, and legs. 

While such pain can be disruptive, leading to sleep problems that accumulate and compound, there are some basic steps you can take to ensure a good night’s rest.

What Is a Sciatica?

Sciatica refers to pain that originates in the sciatic nerve1. As such, this pain may course through your lower back, down into your buttocks and thighs, and even out into your legs. 

The most common sciatica symptoms2 include:

  • Back Pain
  • Hip Pain
  • Shooting Pain
  • Numbness
  • Tingling
  • Muscle weakness
  • Pain in the leg or foot

For those with sciatica, this pain and discomfort may worsen during the following circumstances2:

  • After sitting or standing
  • At night
  • When sneezing, coughing, or laughing
  • While bending backward or walking more 
  • During bowel movements

Naturally, the experience of intense pain can make it challenging to get comfortable in your bed or to get a restful night’s sleep. Before we get into remedies for sciatica, though, it’s important to take a closer look at the causes of sciatica.


What Causes Sciatica?

There are various reasons why someone might have sciatica, but generally, they boil down to the same thing: damage or pressure of the sciatic nerve, leading to inflammation and pain.2

Degenerative Disc Disease 

Spinal discs function as “shock absorbers” within the spine. Over time, these discs can become damaged, which may cause pain at any point along the spine, including, potentially, the sciatic nerve.

Lumbar Spinal Stenosis

This condition refers to a narrowing of the spinal canal3, which can pinch the nerves leading from the lower part of the back down to the legs. Often, the sciatic nerve is included here.

Read More: Best Mattress for Spinal Stenosis

Spondylolisthesis

Those who have spondylolisthesis4 experience pain due to one of their lower vertebrae slipping out of place and moving onto the underlying bone. This condition may be caused by age, but it’s more often associated with sports injuries. Sometimes the displaced vertebra will compress the sciatic nerve, which causes pain.

Muscle Spasms

Muscle spasms can sometimes place pressure on the sciatic nerve. As the Cleveland Clinic5 notes, this is most commonly a result of piriformis syndrome, a fairly unusual neuromuscular disease.

Pregnancy

Sciatica is a common side effect of pregnancy, though not necessarily for the reason you’d think. Many assume that pregnancy causes sciatica due to weight gain, but actually, experts say it has more to do with hormonal shifts that loosen the ligaments6. Ligaments hold the spine together, and as they get looser to prepare for birth, the spine can become unstable, potentially causing trauma to the sciatic nerve.6

Learn More: How to Relieve Sciatica Pain During Pregnancy


Sciatica and Sleep Problems

No matter the specific cause of sciatica, the effect is pretty consistent: Chronic pain, which may ebb and flow in intensity throughout the day. Often, this chronic pain can result in sleep issues. 

According to one study, somewhere between 50 and 80 percent7 of those with chronic pain also have ongoing problems with sleep. In another study8, about half of those with chronic pain also say they have insomnia.

Many researchers say that there’s a reciprocal relationship at play here. On the one hand, deep pain may make it hard to get comfortable and get sufficient sleep at night. But, there is also evidence that those who are sleep-deprived may develop a lower threshold for pain9.

It’s also important to note that bad sleep habits may exacerbate pain, specifically by placing unnecessary pressure on the sciatic nerve.


Best Sciatica Sleep Positions

This raises a critical consideration for those who struggle with sciatica: One of the best remedies of all is simply altering your sleep position. There are a few sleep positions that help shift strain from that sciatic nerve.

Sleeping On Your Back

Sleeping on your back is an excellent way to help even out your weight distribution to ease pressure on the back. Ideally, your mattress should support your lower back but still provide some pressure relief to the joints and muscles.

Learn More: How to Sleep on Your Back

Sleeping On Your Side

While you don’t want to sleep in a fetal position, sleeping on your side can be acceptable. Because you’re not sleeping directly on your back, there’s not as much pressure on the sciatic nerve (nor on your discs or muscles). For best results, curl the knees ever so slightly toward the chest, and keep your hips straight.

Learn More: How to Sleep on Your Side

Elevate Your Knees

Back sleepers may wish to elevate their knees, using one or more pillows. (Use as many as you need to feel comfortable.) This offers further pressure relief for your lower back and sciatic nerve. You may want to test different-shaped pillows, as well as different materials (down and memory foam usually work best).

One thing sciatica sufferers should avoid? Stomach sleeping, which places far too much pressure on your nerves and can compound pain considerably.

Learn more about sleeping with your legs elevated here.

However, the one position people with sciatica should avoid is sleeping on their stomach. The reason for this is that it places far too much pressure on your nerves and can compound pain considerably.


Tips for Alleviating Sciatica Pain

Your sleep position is one way to alleviate sciatica pain, but there are a few other remedies that can also help.

Change Your Mattress

The right mattress is crucial, as it can help to evenly distribute your body weight and keep the pressure off your lower back. Those with sciatica generally benefit from a medium-firm mattress because they are often ideal for providing both good body support and pressure relief. Memory foam, hybrid, and latex mattresses can all be good mattresses for sciatica pain.

Use a Body Pillow

Another option is to use a body pillow, or if you don’t have one, just sleep on your side with a regular pillow placed between your knees. This helps align the spine, hips, and pelvis, which can ease the tension and pressure you experience along the sciatic nerve.

Stretching 

Some strategic stretching can also help alleviate lower back pain by keeping the lower back muscles strong and flexible, which may soothe the symptoms of back pain while also preventing additional flare-ups. 

An example of a good stretch for sciatica is Child’s Pose10, which is when you start on all fours and then sink backward, letting your weight move into your backside and thighs.

More: Best Yoga Poses for Better Sleep

Develop a Nightly Routine

The right bedtime routine may also help. Start with a soothing bath, do some light stretching, put on some comfortable pajamas, and then spend a few minutes relaxing with a good book. All of this can help clear your mind and minimize pain in your body. 

What you don’t want to do is spend a lot of time on your smart device. These types of devices emit a blue light11, which may disrupt your circadian rhythms and make it tougher for you to fall asleep.

Medication

Finally, note that there are plenty of medications that may alleviate lower back pain and help you fall asleep. Start with over-the-counter pain relievers, such as ibuprofen. If those medications are ineffective, ask your doctor about anti-inflammatory prescriptions, which may minimize the irritation of the sciatic nerve and thus decrease your pain.

Alesandra Woolley

Alesandra Woolley

Editor

About Author

Growing up in the City That Never Sleeps, she learned the hard way how important a good night of rest really is. She’s made it her mission to help others realize the same. On any given day, you’ll find Alesandra in our Mattress Lab testing the latest mattress models, interviewing specialists on the importance of sleep, or curating the most helpful content for our readers. Alesandra’s been featured in Business Insider, USA Today, MarketWatch, Elite Daily and the NY Post for her perspectives on sleep health.

Stomach Sleeper

Education & Credentials

  • Certified Sleep Science Coach

References:

  1. “Sciatica”. Johns Hopkins Medicine. Webpage accessed February 1, 2024.
  2. “Sciatica”. Penn Medicine. Last modified September 20, 2022.
  3. “Lumbar Spinal Stenosis”. American Associations of Neurological Surgeons. Webpage accessed February 1, 2024.
  4. “Spondylolisthesis”. Cleveland Clinic. Last modified August 7, 2020.
  5. “Sciatica”. Cleveland Clinic. Last modified May 21, 2023.
  6. “Sciatic Nerve Pain During Pregnancy”. Penn Medicine. Webpage accessed February 1, 2024.
  7. Cheatle PhD, Martin D., et al. “Assessing and Managing Sleep Disturbance in Patients with Chronic Pain”. Anesthesiology Clinics. 2016.
  8. Purushothaman, Balaji., et al. “Prevalence of insomnia in patients with chronic back pain”. National Library of Medicine. 2013.
  9. Haack, Monika., et al. “Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications”. Neuropsychopharmacology. 2019.
  10. “Stretches and Exercises to Ease Sciatica Pain, from a PT”. Hospital for Special Surgery. 2022.
  11. “Blue light has a dark side”. Harvard Health. 2020.