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 who suffer from 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 radiates along the sciatic nerve. As such, this pain may course through your lower back, down into your buttocks and thighs, and even out into your legs. Generally, those who have sciatica find that it impacts just one side of their body.

The most common sciatica symptoms include:

• Back Pain
• Hip Pain
• Shooting Pain
• Leg Pain While Sitting
• Numbness
• Tingling
• Muscle weakness

For many sciatica sufferers, the pain is especially bad when they cough, sneeze, or laugh. Also note that sciatica can sometimes lead to loss of bladder or bowel control, though this is a rare, extreme symptom. 

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 (including some insomnia aids), it’s important to take a closer look at the causes of sciatica.

What Causes Sciatica?

There are a number of reasons why someone might suffer from sciatica, but generally they boil down to the same thing: Pinching or pressure of the sciatic nerve, leading to inflammation and pain.

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 canal, which can pinch the nerves leading from the lower part of the back down to the legs. Often, the sciatic nerve is included here.

Spondylolisthesis

Those who have spondylolisthesis experience pain due to one of their lower vertebrae slipping out of place, 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 Clinic 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 the weight gain, but actually, researchers say it has more to do with hormonal shifts that loosen the ligaments. Ligaments hold the spine together, and as they get looser, the spine can become unstable, potentially causing trauma to the sciatic nerve.

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% of those with chronic pain also have ongoing problems with sleep. In another study, about half of those who suffer from chronic pain also say they have insomnia.

Many researchers say that there’s a reciprocal relationship in play here. On the one hand, deep pain may make it hard to get comfortable and to get sufficient sleep at night. But, there is also evidence that those who are sleep-deprived may perceive pain more acutely when they wake up the next day. “While poor sleep doesn’t cause additional pain, it can make you extra sensitive to the sensation of pain,” notes an article from Keck Medicine of USC.

It’s also important to note that bad sleep habits may exacerbate pain, specifically by placing unnecessary pressure on the sciatic nerve. “If you find yourself waking up with worse pain than the night before, chances are that your sleeping habits are aggravating your sciatica by placing undue stress on the sciatic nerve,” says an article from Pain Management and Injury Relief. This is particularly common among those who sleep in a curled or fetal position, which pinches the nerve and results in shooting pain.

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 are especially therapeutic, helping shift strain from that sciatic nerve.

Sleeping on Your Back

Most sciatica sufferers find that sleeping in a supine position offers the best pain relief. Remember, the pain of sciatica comes from irritation of the sciatic nerve, which is located in the lower part of your back. Sleeping in a supine position is the best way to keep the pressure off that part of your body.

Sleeping on Your Side

While you definitely 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.

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.

General for Alleviating Sciatica Pain

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. Memory foam, innerspring, and latex mattresses can all be good mattresses for alleviating 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. There are a number of stretches that help keep muscles in the lower back strong and flexible, which may soothe the symptoms of back pain while also preventing additional flare-ups. 

Develop a Night Time Routine

The right bedtime routine may also help. Start with a soothing bath, do some light stretching, put on some comfortable pajamas, 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, which emits blue light that 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.