Sleep and pain are closely linked in a two-way relationship. Poor sleep can make pain worse, and pain can interrupt sleep. Research shows that even one night of insufficient sleep can make people feel more pain the next day. At the same time, people who live with chronic pain often find it hard to fall or stay asleep. This cycle, where pain disrupts sleep and sleep loss increases pain sensitivity, can seriously affect their quality of life.
Recent studies help explain how this works. A review in Sleep Medicine Reviews found that poor sleep affects the brain's pain control systems, making people feel more pain after not sleeping well.¹ Other research from The Clinical Journal of Pain shows that not sleeping enough lowers the body's ability to block pain.² This means sleep problems can make the nervous system more pain-sensitive.
Pain isn't only affected by how long we sleep and how we sleep. Colleagues and I have researched how sleep posture, the way in which we position our bodies during sleep, affects waking spinal pain.
| Our four key sleep postures |
Our 2019 scoping review, published in BMJ Open, found that certain sleep positions, such as stomach-lying or rotated side-lying postures, are associated with increased back and neck pain, particularly when maintained for prolonged periods.³ Side-lying positions, with neutral spinal alignment, were found to reduce symptoms. Our cross-sectional study, published in PLOS ONE (2021), confirmed that non-neutral sleep postures were associated with increased waking spinal symptoms and poorer sleep quality.⁴
We are awaiting the release of our longitudinal study, in which we employed an educational intervention, commonly performed in-clinic, to assess participants' ability to influence their sleep posture and subsequent changes in sleep quality and morning waking spinal pain.
These findings are essential for people presenting with acute or persistent back or neck pain. Educating patients on better sleep postures, such as sleeping on the side with proper bracing, may reduce pain and improve sleep quality. Improving sleep can also enhance the effectiveness of pain management programs. Using sleep-friendly postures and adhering to a regular sleep routine are simple, drug-free ways to support pain reduction and improve sleep quality.
You can;
- Read free copies of each research paper
- Undertake the fun and informative 14-night Sleep Posture Challenge (guided email sequence - learn about sleep posture, sleep system,s and sleep client education)
- Dive in deep and start your step-by-step learning journey with the unique Sleep Mastery Course.
References
- Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. Sleep Med Rev. 2013;17(6):333-342. doi:10.1016/j.smrv.2013.01.005
- Haack M, Sanchez E, Mullington JM. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Sleep. 2007;30(9):1145-1152. doi:10.1093/sleep/30.9.1145
- Cary D, Collinson R, Sterling M, et al. Sleep posture as a potential contributor to non-specific spinal symptoms and sleep quality: a scoping review. BMJ Open. 2019;9(6):e027633. doi:10.1136/bmjopen-2018-027633
- Cary D, Olds T, Hill K, et al. Relationship between sleep posture and spinal symptoms in the habitual sleeping environment. PLoS One. 2021;16(11):e0260582. doi:10.1371/journal.pone.0260582