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Sleep and Spondylitis: Tips for a Better Night’s Rest

Updated on February 07, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Sarah Winfrey

Troubles with sleeping are common among people with spondylitis. In fact, in one study of 314 people with ankylosing spondylitis (an advanced form of spondylitis), 58 percent of participants reported they struggled to sleep well. The troubles may be due to chronic pain (especially nighttime back pain) and other symptoms of spondylitis, like depression and anxiety, which can also keep you up at night.

Due to their spondylitis symptoms, some people may deal with sleep disturbances, such as waking in the middle of the night. In fact, according to one study of 55 people with spondylitis that was published in 2015, participants who reported experiences with poor sleep quality noted that their problems were more likely to occur when their symptoms were actively flaring. Like others with the condition, they may have slept for a shorter amount of time overall, and, as a result, faced daytime fatigue and exhaustion.

If these issues sound familiar, you may find relief with these tips for spondylitis-associated sleep problems. Armed with these ideas, be sure to consult your doctor before making any changes. By working with your health care team, you can best uncover the roots of your sleep problems, and settle on the most effective ways to manage them.

How People With Spondylitis Experience Sleep Problems

Many MySpondylitisTeam members who don’t sleep well often share that pain is the main culprit. As one member wrote, “I only sleep four hours — at most — until the pain wakes me. Then, I do something or watch a show, and fall back asleep when I can.” Another explained, “Struggling with back pain and lack of sleep is awful. I’ve tried everything to get the pain to stop, but nothing works.”

Such longing for quality rest is common. “I’m just trying to go to sleep,” wrote one member, “but I can never fall asleep, much less get in a comfortable position. I wish I could get some relief and a much-needed, good night’s sleep for once.” Another expressed a similar sentiment, and shared, “I can fall asleep, but only for a few hours. Then, it’s tossing and turning, trying to get comfortable again. I just want to rest.”

Sleepiness, brain fog, and frustration: How to manage fatigue in spondylitis

Not sleeping well can also cause problems in the daytime. You may find yourself struggling to get through the day and complete daily tasks, like the member who wrote: “I can’t sleep really well, and I am having a hard time functioning from the lack of sleep.” Exhaustion and fatigue can lead to irritability, as well. As one member described, “I’m not feeling good because I didn’t get enough sleep, and so I’ve been moody. I’m taking it out on my husband, and it’s not fair to him.”

How To Manage Spondylitis-Associated Sleep Problems

Trying these techniques may help you get better quality sleep, and more sleep altogether. Remember to ask your rheumatologist or other health care provider for their medical advice before making any changes to your treatment plan or daily routine. They can often quickly outline the right treatment to get you the sleep you need.

Get a Good Mattress

A mattress that supports your body properly can make a huge difference when it comes to quality sleep. Make sure that your mattress has plenty of support and doesn’t force you to bend or twist your spine in ways that may cause pain, be that immediate or felt hours later.

One MySpondylitisTeam member shared how finding a new mattress made a huge difference. “I had to move recently, so I took the opportunity to buy a completely new bed,” they said. “I did a ton of research, and it has changed my life! I’m now sleeping seven to eight hours a night, with barely any pain upon waking.”

It may take a few tries to find the right mattress for you. Fortunately, many mattress companies have trial periods, so you can get a refund and try another mattress if one doesn’t work for you.

Find the Right Position

The position you sleep in may be contributing to pain you feel at night and upon waking. Sleeping on your stomach in particular can often cause significant back pain for people with arthritis, especially if they’ve been diagnosed with spondylitis. A shift to sleeping on your back may make a huge difference in how much pain you experience.

You can also use pillows to support yourself in the best sleeping position. Some people sleep with pillows under their knees while lying on their backs. To alleviate lower back pain, others sleep on their side with a pillow between their legs. You may also want to try a thin pillow under your head to prevent or alleviate pressure on your neck and cervical spine.

Some members have found that pillows are lifesavers at night. One wrote, “I have found that if I put my legs up on pillows and hook my legs over them, it seems to take the pressure off the nerves in my back, and I can actually sleep for a few hours at a time.” Another explained, “I sleep with two body pillows. One is up against my back, and the other is in front of me with my leg bent over the pillow, on my side. It takes the pressure off my lower back.”

It may take some experimenting, but using pillows the right way could help you sleep better.

Try a Sleep Medication

If nothing else works, you and your doctor may want to consider prescription sleep medications. Some people with spondylitis find that these medications make a huge difference in how well they sleep.

Some MySpondylitisTeam members described their experience with sleep medications. “I take trazodone at night,” one wrote. “It works quickly.” They then warned of the “window of opportunity” they’d encountered with the medication. “If you try to muscle through the extreme tiredness it creates,” they posted, “then later you WILL NOT be able to fall asleep.” There are scores of prescription sleep medications available, so talk to your doctor about which options may be most helpful for you.

Some natural substances might also help you get a better night’s sleep. Talk to your doctor about taking a melatonin supplement. If cannabis is legal in your area (be that for medical or recreational use), cannabis-based products might help you sleep. One member explained, “I tried a new product from my cannabis dispensary and got the best sleep that I’ve had in years! I woke up, and I was sleeping on my back. I can never sleep on my back.”

As always, talk to your doctor before trying any new supplements or medications for sleep, even natural ones.

Manage Your Pain

Keeping your pain well-managed may help you sleep better, too. You may need to be on different medication altogether, or simply different dosages of what you are already taking. Your doctor may also recommend supplementing your existing prescription with over-the-counter drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs).

If you presently experience pain at night, you may also need to take your medication at a different time (or times) of day than you you do now. Before you do so, though, talk to your doctor about how to schedule your dosing so your medication still works all night long.

Practice Good Sleep Hygiene

Give yourself the best possible chance of falling asleep — and staying asleep. Establish a bedtime routine so that your body and mind are primed to doze off when it’s time to sleep.

Avoid blue light, like the light from phone and computer screens, which can tell your body to stay awake. Other steps for good sleep hygiene, such as avoiding caffeine at night and making sure you have a dark, quiet place to sleep, could make a huge difference in how well you sleep.

Find Your Team

On MySpondylitisTeam, the social network for people with spondylitis and their loved ones, more than 85,000 members come together to ask questions, give advice, and share their experiences with others who understand life with the condition.

Have you had sleep difficulties with your spondylitis? What helps? Share your experience and tips in the comments below or by posting on MySpondylitisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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