Getting Your Best Sleep

Forty-five percent of Americans say that poor or insufficient sleep affected their daily activities at least once in the past seven days, according to the National Sleep Foundation’s inaugural Sleep Health Index™. That coincides with the over 70 million Americans who suffer from disorders of sleep and wakefulness.

Jonathan Simhaee MD is board certified in Physical Medicine and Rehabilitation at The Center for Musculoskeletal Disorders in Englewood, NJ and is also fellowship trained in Spine and Interventional Pain Management. He gives useful advice below on how to maximize sleep.

Do you have any specific pillows you recommend for back pain sufferers? (if so, what are they?)

Proper rest and a good night’s sleep are the body’s chance to heal itself from the postural and taxing stresses it experiences during the day. Without question, a good night’s rest is essential. The use of the proper pillow can improve the quality of that rest, allowing one to wake up refreshed and ready for the challenges of another day.

For people with spinal disorders, the right type of support can be especially important in helping the spine to rest comfortably. For example, most soft pillows (i.e., down or feather) offer very little support compared to firmer pillows.

However, I always ask my patients if they are side sleepers or stomach sleepers as there are specific pillows for both sleeping types. Anecdotally, people who suffer from low back pain often seem to experience a more restful night’s sleep with a firmer pillow.

Is it mainly people with low back pain who have trouble sleeping or are there a variety of spine or muscle issues that can hinder someone’s ability to sleep?

Of course, many people have difficulty falling asleep, and some even staying asleep. Many spine and muscle issues can be a hindrance to a good night’s rest. Therefore, it is important to target the root of the specific problem to enable proper sleep.

Are your recommendations very different for example sciatica sufferers vs. people with chronic back pain?

My general rule of thumb doesn’t differentiate between acute and chronic pain or types of related pain. Firmer surfaces and firmer pillows are generally more acceptable. Having said that, a chronic pain sufferer has likely found a surface and pillow that may represent a “happy medium”. If so, I would not alter something that is working well.

Is it realistic for people to switch sleep positions they’re naturally inclined to, such as stomach sleeping? Do you recommend they try to change the way they sleep if possible?

Generally speaking, I would not ask my patients to switch or alter their sleeping habits if there is no specific cause for concern. If one sleeps well on the stomach, I would continue doing the same. Conversely, if one does not wake up refreshed and is having low back pain, it may be wise to try something different/new in sleeping position.

When sleeping on the side, bending the knees and placing a pillow between the knees prevents the knees from the act of adduction (or joining together). Avoiding adduction keeps the spine in the neutral position. Therefore, a pillow between the legs is a great way to unload unwanted stress on the low back.

When sleeping on the back, placing a pillow underneath the back of the knees helps reduce the load on the lower back, putting less force on the pain-sensitive “Z” joints of the spine. This position may be the best overall to help the back rest comfortably, especially during an acute back pain attack or while recovering from spine surgery.

With this in mind, I usually recommend a short trial (only a few days would be necessary) of a pillow to see if it results in rest that is more refreshing. Remember, no two spines are alike. What may work for some, may not work for others!

Do you have recommendations for the waking hours that might help back pain sufferers sleep better?

The best approach is to get to the root of the problem. If one is having trouble sleeping due to lower back pain, I recommend a visit to a specialist in Interventional Pain Management. When the underlying conditions of the pain are treated, one’s rest should undoubtedly be more refreshing!