People living with scoliosis, an abnormal curve in the spine, may find it challenging to get comfortable at night. This discomfort can lead to tossing and turning, or pain, which can make sleep feel all but impossible. Luckily, there are a few simple changes you can make that can help if you’re struggling to sleep with scoliosis.
In this article, we’ll talk about how scoliosis affects sleep and what you can do to improve your sleep. Most of these tips are simple lifestyle or sleep position changes that you can implement starting tonight. If you have scoliosis and have been struggling to get comfortable at night, we hope these adjustments have you sleeping more soundly in no time.
Scoliosis1 is a neuro-muscular condition characterized by an abnormal curvature of the spine. The abnormality can range from as small as a 20-degree curve to as much as a 50-degree curve.1 Instead of the spine traveling down the body in a straight line, it could form a C or S shape.1 Scoliosis is not usually painful in mild or pediatric cases. However, when left uncorrected, it could cause pain or mobility issues in adults.
There are three types2 of scoliosis: Congenital, neuromuscular, and idiopathic.
Congenital scoliosis is caused by a malformation of one or more vertebrae during the embryo’s development2 It is usually detected much earlier than other types of scoliosis since the person will be born with this spinal curvature.
Neuromuscular scoliosis is caused by an underlying neurological issue, like cerebral palsy, spinal cord trauma, spina bifida, etc.2 This type of scoliosis tends to progress rapidly and often requires treatment.2
Finally, idiopathic scoliosis is the diagnosis when all other underlying causes have been eliminated.2 This is the most common type of scoliosis, and it is typically diagnosed between the ages of 10 and 15.2
The earliest detectable symptoms of scoliosis include2:
- Uneven shoulders
- Uneven hips
- Rib cages at different heights
- The head is not directly straight above the pelvis
- Uneven waist
- Changes in the skin over the spine (color abnormalities, dimples, patches of hair)
- The entire body leans to one side
Sometimes people with scoliosis report back pain, but often in the earliest stages this isn’t the case, so doctors evaluate X-rays or perform physical examinations looking for these symptoms.
The Effect of Scoliosis on Sleep
Although many things can cause insomnia, idiopathic scoliosis, in particular, is linked to genetic deficiencies that may make sleeping difficult for some individuals. For example, teens with idiopathic scoliosis have low melatonin levels3. Melatonin is the hormone that makes us sleepy as it starts to get darker at night. If somebody has lower levels of melatonin, it can be harder for them to fall asleep at night.
Additionally, scoliosis can cause poor pulmonary function, resulting in impaired breathing and sleep apnea4. With sleep apnea, the sleeper starts and stops breathing repeatedly, which causes them to wake up throughout the night in order to get enough oxygen.
Moreover, people with scoliosis may struggle to sleep because of pain and discomfort in their body. However, the actual magnitude of the spine’s curve doesn’t have much effect on sleep quality5, meaning that anyone with scoliosis, regardless of how severe it is, could potentially struggle with sleep deprivation and daytime sleepiness.
1. Get a Supportive Mattress
While a bad mattress won’t make scoliosis worse, you’re not doing your back any favors by lying on a bed that’s unsupportive. Further, it could make any pain you have more pronounced.
While soft and cushy mattresses are tempting, you’ll be better off with a medium-firm or firm mattress that allows your spine to remain in a well-supported, neutral position.
When you’re shopping for a new mattress, one of the things to look for is a mattress trial period. This sleep trial allows you to try the bed in your home for a limited amount of time to see if the bed is right for you. Many reputable companies offer a risk-free trial that’s 90 to 365 days long.
Check Out Our Guide: Top Rated Mattress for Scoliosis
If you’re not ready to buy a new bed, consider getting a mattress topper. As your bed gets older, it can start sagging and not provide the support you need. A mattress topper could give you additional lift for spinal alignment and may even extend your mattress’ life for another year or more.
2. Avoid Sleeping On Your Stomach
Stomach sleeping can be problematic even for individuals with healthy spines, so if you have scoliosis, we advise that you avoid sleeping on your stomach unless directed otherwise by your physician. Not only does this position often cause your head and neck to twist at unnatural angles, but it could also cause your spine to arch further out of alignment.
For people who can’t sleep in any other position, we usually recommend placing a pillow under the pelvis to better align the spine and prevent arching. If you have scoliosis, though, you’ll want to talk to your doctor first, since the curve of your spine will be unique.
Want to know more? Check out our guide for the best pillow for stomach sleepers.
3. Sleep On Your Back or Side
Many scoliosis patients find that sleeping on their backs5 is the best way to keep their spine neutral. However, you should avoid creating too much pressure on the lower back. Therefore, we recommend placing pillows or rolled-up towels under your shoulder blades and at the base of your spine.
Make sure your pillow isn’t too high or low. You don’t want to be propped up or sinking down into the mattress, and your spine should remain relatively flat and parallel to the bed.
The advantage of side sleeping for patients with scoliosis is that this position is considered to be relatively healthy for spinal alignment. However, for those with a more pronounced curve on one side or the other, consider how your spine is shaped; if the biggest curve is on the right side of your body, then sleep on your left side, and vice versa. Side sleeping should also help with breathing issues caused by scoliosis.4
4. Use Pillows for Support
Pillows can be great for keeping your spine in proper alignment and help ensure your comfort all night long. You don’t want to sleep on a mountain of pillows that will throw your neck and back out of alignment. Instead, you want your spine and head to be as well aligned as possible.
For side sleepers, a pillow between the knees should help the spine stay in a neutral position and prevent twisting. Underneath the head, side sleepers can generally have thicker pillows, as the pillow will need to fill in the space from the neck to the end of the shoulder, but stomach and back sleepers typically need a cushion with a smaller profile to keep the spine as straight as possible.
Adjustable pillows are also a good option for people with scoliosis as they may experience numbness7 in the shoulder areas. With these pillows, you can remove the filling and easily change the height of the pillow, depending on your needs. Memory foam works well, too, as it contours to the shape of the head and neck and lessens pressure in these areas.
Consult with your doctor to make sure you’re using pillows to support you properly and not doing your spine any harm by putting it at an inappropriate angle. A lack of knowledge could lead to increased pain or discomfort.
View Our Guide: Best Pillow For Side Sleepers
5. Practice Good Sleep Hygiene
Sleep hygiene refers to your sleeping and bedroom habits. The best thing you can do to ensure a restful night — other than having the perfect bed — is to practice habits that support healthy sleep.
The ideal bedroom should be between 60 and 67 degrees, as dark as possible, and noise free. This might mean you need blackout curtains, an eye mask, or a white noise machine, depending on your living situation.
You should also develop a regular bedtime routine. This routine should help signal to your mind and body that it’s time to get ready to go to sleep. For example, drinking some chamomile tea, reading a book, meditating, journaling, or taking a bath – anything that is relaxing and doesn’t stress you out or elevate your heart rate. Avoid looking at screens for one hour before bed, as they emit blue light, which can delay sleep onset8.
A good bedtime routine also includes going to bed and waking up at the same time each day, establishing a consistent schedule.
6. Try Sleeping Aids
We mentioned earlier that melatonin deficiency plays a role in the prognosis of idiopathic scoliosis.3 More research is needed, but recent studies show promising results in using melatonin supplements to treat the curve of the spine in scoliosis.3 Melatonin deficiency can also make it much more difficult to fall asleep, so taking these supplements may help in more ways than one.
If you are new to taking melatonin, we suggest starting with just a small amount – 1 milligram to 3 milligrams. However, before taking any, it’s a good idea to check with your doctor first, especially if you take any medications.
With melatonin, more is not necessarily better, and in fact, too high a dose can make you drowsy the next day. Unless your doctor advises it, there’s no need to take more than 5 milligrams9 at night about one to two hours before bedtime. Consult your doctor to find what will work best for you.
Find Out More: Best Sleep Aid Supplements
What are some natural ways to improve my scoliosis?
People with more severe cases of scoliosis are often seen wearing a back brace, which can be bulky and uncomfortable, thus making it harder to find a suitable sleep position. However, there are lighter-weight options on the market that look and feel more like a wrap than an inflexible brace. These allow for more natural movements and can be worn to bed.
Improving scoliosis through exercise10 is also an option as it can help strengthen the back and abdominal muscles surrounding the spine. In fact, when scoliosis is first detected, certain exercises may help prevent its progression.10
Practicing a healthy diet is beneficial as well. Focus on consuming foods that help increase bone density, promote muscle growth, and keep your body at a healthy weight, as being underweight or severely underweight increases the risk of developing or worsening scoliosis11. Some examples of good foods12 for scoliosis are fresh fruits and vegetables, lean proteins like fish, and foods rich in calcium, vitamin D and B, along with drinking lots of water throughout the day.
What are the best exercises for scoliosis?
The best exercises for scoliosis are ones that will strengthen the back and core. We recommend the following stretches to help stabilize the spine and provide pain relief:
- Exercise ball stretch: Lie on your side with the ball pressing into your side. Your feet and one hand will remain on the floor for stabilization. The hand that’s not on the floor will stretch forward over your head. Start on one side, hold for 20 seconds, and then switch. Repeat three times.*
- Foam roller towel stretch: Lie across a foam roller that’s covered with a towel. You’ll be in the same position as the first exercise that you did on the ball.*
- Partner stretch: Lie on your stomach with your torso, head, and neck above the floor. Rise into a plank position and have your partner support you to keep your back level.*
*Keep in mind these should be performed delicately and only if comfortable. We advise you to seek a professional’s advice before doing any strenuous movements.
Any tips for sleeping with a back brace?
First, you should be extra diligent about keeping the back brace dry. If moisture gets in, it could cause skin ulcers or a rash. Another helpful tip is to sleep on your back with a pillow under your legs, which will hopefully prevent the brace from digging into your body.
Finally, you may have discovered that it can be difficult getting in and out of bed with a back brace. To make things less challenging, instead of trying to sit up, roll to the side of the bed you wish to exit with your face down, push yourself up with your arms, and then gently move your legs off the bed. You should then be able to push yourself up and off the bed.
Is it good to sleep on the floor if you have scoliosis?
Sleeping on the floor is not recommended if you have scoliosis because it doesn’t allow your back to align properly. Instead, people with scoliosis should sleep on a mattress that is semi-firm and allows the curve of the spine to sink into the mattress while still being supported by a relatively firm surface.
Is sleeping without a pillow good for scoliosis?
If you have scoliosis, you should try to sleep on your side or back, which is typically more comfortable with a pillow. Without one, your head and neck may not get the necessary support, throwing your spine out of alignment. This misalignment could worsen your scoliosis symptoms, pain, and pressure. On top of that, you may want to consider adding a pillow under your lower back if you’re a back sleeper, or between your knees if you’re a side sleeper.
What can worsen scoliosis?
Scoliosis symptoms can worsen due to many factors, including certain sports that put uneven force13 on one side of the body for long periods of time. Golf, tennis, and figure skating are some examples.13
You’ll also want to avoid14 certain yoga positions, competitive swimming (for long periods of time), football, sleeping on your stomach, long-distance running, and carrying heavy items. Also, sleeping with lights on may throw off your melatonin production, which can then worsen scoliosis. Being on your phone too much may also worsen scoliosis because the bent-head position pressures the spinal cord and may cause chronic neck pain, which causes scoliosis progression.14
All that said, scoliosis is progressive, which means it usually gets worse with age15, perhaps even if you are diligently avoiding all of these activities. However, it’s difficult to predict how much scoliosis will progress and after how many years. The condition is subject to unpredictable and quick changes, likely with both severe cases and smaller curves in the spine.15 This unpredictability is why getting an early diagnosis and seeking medical care early on is important.
Rachael is a content writer for Sleep Advisor who loves combining her enthusiasm for writing and wellness.
- Shah MD, Suken A., McCarthy, Alicia. “Scoliosis”. Nemours Teens Health. https://kidshealth.org/en/teens/scoliosis.html. 2017.
- “Scoliosis”. American Association of Neurological Surgeons. Webpage accessed July 15, 2023. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis.
- Liu, Hao., Man, Chi-Wai., et al. “The effect of exogenous melatonin on reducing scoliotic curvature and improving bone quality in melatonin-deficient C57BL/6J mice”. Scientific Reports. https://www.nature.com/articles/s41598-019-42467-5. 2019.
- Li, Xingye., Guo, Haiwei., et al. “Does Scoliosis Affect Sleep Breathing?”. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/30036713/. 2018.
- Yakut, Yavuz., Pelin, Zerin., Yagci, Gozde. “An investigation of sleep profiles in individuals with idiopathic scoliosis”. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210568/. 2022.
- “How To Sleep With Scoliosis: Sleeping With Scoliosis”. Clear Scoliosis Institute. Webpage accessed July 15, 2023. https://clear-institute.org/blog/how-to-sleep-with-scoliosis/.
- “Adult Scoliosis”. University of Connecticut Health. Webpage accessed July 15, 2023. https://health.uconn.edu/spine/conditions-and-treatments/adult-scoliosis/.
- “Blue light has a dark side”. Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side. 2020.
- “Melatonin”. Family Doctor. Last modified June 1, 2023. https://familydoctor.org/melatonin/.
- “First Signs of Scoliosis and What to Do When they Appear to Stop Its Progression”. Align Clinic. https://www.align-clinic.com/blog/first-signs-of-scoliosis-and-what-to-do-when-they-appear-to-stop-its-progression. 2020.
- Jeon, Kyoungkyu., Kim, Dong-il. “The Association between Low Body Weight and Scoliosis among Korean Elementary School Students”. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313767/. 2018.
- “Scoliosis Nutrition & Diet: What Foods Can You Eat?”. Clear Scoliosis Institute. Webpage accessed July 16, 2023. https://clear-institute.org/blog/scoliosis-nutrition/.
- “Scoliosis and Swimming: Myths and Does it Help?”. Clear Scoliosis Institute. Webpage accessed July 16, 2023. https://www.scoliosisreductioncenter.com/blog/scoliosis-and-swimming.
- Siddiqui, Aatif. “Scoliosis Do’s and Don’ts (Scoliosis Self-Care)”. Scolio Smart. Last modified March 31, 2023. https://treatingscoliosis.com/scoliosis-dos-and-donts/.