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How to Sleep with Sciatica

Last Updated on April 30, 2024

Written by Alesandra Woolley, Expert Reviewed by Dr. Heidi Moawad, MD

Alesandra Woolley

Written by Alesandra Woolley, Writer

Our Research Process

Here at Sleep Advisor, our editorial team utilizes reputable sources and expert feedback to provide well-researched sleep health content. For more details, read our full editorial policy. 

In This Article

How sciatica can keep you up at night— and what you can do about it.

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 intense pain in the back, hips, buttocks, and legs. 

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

Looking for a sleep solution? Find the best mattress for sciatica here. 

What Is Sciatica?

Sciatica refers to pain that originates in the sciatic nerve1. The sciatic nerve is the largest nerve2 in the human body, which is why sciatica can be especially common. This nerve starts at the lower back and goes all the way down to the heels on our feet. As such, this pain may course through your lower back, down into your buttocks and thighs, and even out into your legs. 

Symptoms of Sciatica

The most common sciatica symptoms3 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 circumstances3:

  • 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.3

  • 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 canal4, which can pinch the nerves leading from the lower part of the back down to the legs. Often, the sciatic nerve is pinched or compressed when this happens. Read More: Best Mattress for Spinal Stenosis
  • Spondylolisthesis – Those who have spondylolisthesis5 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 underlying nerves.  As the Cleveland Clinic6 notes, this is most commonly a result of piriformis syndrome, which is when the sciatic nerve is compressed by the piriformis muscle.
  • 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 ligaments7. 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.7

Learn More: How to Relieve Sciatica Pain During Pregnancy

How to Sleep With Sciatica: Components to Consider  

Sleeping Position 

If you’ve been diagnosed with sciatica, you’ll want to choose a sleeping position that can help decrease pressure on the sciatic nerve, while also keeping your spine in proper alignment, explains pain management doctor Taher Saifullah, MD, founder of Spine and Pain Institute in Los Angeles.

He recommends two options: sleeping on your back or your side.

For back sleepers, place a “pillow under the knees to diminish any arch in your lower back,” he says, which can also help distribute weight evenly. Side sleepers, meanwhile, will want to “give their knees a slight tug toward their chest, leaving a pillow between the knees for support.” If you opt for side sleeping, Saifullah suggests avoiding curling into a ball, which can cause spine and hip pain.

Research8 shows that sleep posture can play a key role in increasing or decreasing spinal pain, with side sleeping being the optimal choice for protecting against any spinal symptoms.

Stretching

Saifullah advocates for stretching as one of the best ways to alleviate spinal pain, particularly lower back and hamstring stretches. “Stretches improve flexibility, relieve tension and pressure from the sciatic nerve, and are an important way to manage sciatica pain both at home and on the go,” he says.

Here are three stretches he suggests trying if sciatic nerve pain is keeping you awake at night.

  • Hamstring stretch: Lie on your back, raise one knee, and pull it towards your chest gently. Keeping the other leg flat on the floor. Hold for 15 to 30 seconds, then repeat on the opposite leg.
  • Piriformis stretch: Sit in a chair and cross one leg over the other so that the ankle rests on the opposite knee. Fold forward until you feel a stretch in your buttocks while sitting up straight.
  • Spinal stretch: Lie on your back and pull both knees to your chest, holding them with your hands for 15 to 30 seconds.

Hot/Cold

Alternating heat and ice therapy9 can be a great way to help with sciatica pain. Here’s how Saifullah suggests using both to get better sleep at night.

  • Ice: Wrap small ice packs in a towel and apply to the affected area for 15 to 20 minutes every few hours, especially during the first two days after the onset of any sciatica pain. “Ice helps with reducing inflammation and pain,” he says.
  • Heat: Once the inflammation has passed, begin using heat at the site for 20 to 30 minutes at a time (you can use a heating pad or warm compresses). “Heat relaxes muscles and enhances blood flow, which promotes healing,” he says.

Learn More: Cold Therapy for Sleep and Using a Sauna Before Bed

Consider New Bedding (Mattress/Pillow) 

While Saifullah says there’s no definitive mattress and pillow combination that will work for all, here are a few guidelines to consider if you’re looking to make changes to your bedding to combat new or worsening sciatica pain.

  • Mattress: A medium-firm mattress can provide good support for your back. “Make sure it’s not too soft, otherwise your spine will collapse into the mattress,” Saifullah advises.
  • Pillow: Look for a pillow with a shape, height, and firmness10 that keeps your head naturally leveled with your spine (you don’t want your chin tucked in, for example). “Also consider the manner in which you like to sleep, such as on your back or side, when choosing a pillow,” he says. View our picks for the best pillows here.

Talk to a Doctor

If sciatica pain is preventing you from falling or staying asleep, it may be time to speak to a doctor to develop a new treatment plan or make changes to any current one. “Treating sleep disorders early on may prevent them from becoming chronic and interfering with daytime functioning,” Saifullah says.

A doctor can also help make suggestions for improving sleep, such as changes to your bedding or sleep position (more on that below).

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Alesandra Woolley

Alesandra Woolley

Writer

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.

References:

  1. “Sciatica”. Johns Hopkins Medicine. Webpage accessed February 1, 2024.
  2. Giuffre, Brittney A., Black, Asa C., Jeanmonod, Rebecca. “Anatomy, Sciatic Nerve”. StatPearls. Last modified November 16, 2023.
  3. “Sciatica”. Penn Medicine. Last modified September 20, 2022.
  4. “Lumbar Spinal Stenosis”. American Associations of Neurological Surgeons. Webpage accessed February 1, 2024.
  5. “Spondylolisthesis”. Cleveland Clinic. Last modified August 7, 2020.
  6. “Sciatica”. Cleveland Clinic. Last modified May 21, 2023.
  7. “Sciatic Nerve Pain During Pregnancy”. Penn Medicine. Webpage accessed February 1, 2024.
  8. Cary, Doug., et al. “Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review”. BMJ Open. 2019.
  9. Davis, David., et al. “Sciatica”. StatPearls. Last modified January 4, 2024.
  10. Johnson, Pang Chun-Yiu., et al. “The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality, and spinal alignment in adults: A systematic review and meta-analysis”. Clinical Biomechanics. 2021.