Tips For Sleeping Better With Spondyloarthritis

By Brent Wells, DC

Wednesday, March 27, 2019

As someone suffering from spondyloarthritis, you know just how exhausting it can be to get into a comfortable position at night. Then, when you finally do find something that allows you to rest, pain and stiffness can shake you back awake in the middle of the night.

When you aren't getting enough sleep, your body doesn't have adequate time to repair itself. As a result, you may be more uncomfortable during the day, and then less likely to get a full night's sleep the following night. It’s a cycle that can leave you exhausted, adding on to fatigue and brain fog many with SpA experience. Lack of sleep can also contribute to increased anxiety, depression, and stress.

Below are some tips for a better night’s sleep that we hope will be helpful!

Make Sure You Have A Comfortable, Supportive Bed


With spondyloarthritis, you deal with pain, inflammation, and stiffness that affect not only the back but also the neck, shoulders, hips, and other joints. Your mattress should be friendly to your spine and other joints. Below are suggestions for what to look for in a mattress.

Select a mattress that:

  • • Evenly distributes your weight
  • • Doesn't cause your spine to distort
  • • Is in good/excellent condition
  • • Has a supportive box spring or foundation

Finding a balanced mattress that is somewhere between firm and soft is essential. You don't want a mattress that is too soft because it is not going to give you much support, while a mattress that is too firm won’t mold to the natural curves of your body.

Editor’s Note: SAA’s online community shared their recommendations for specific mattresses and pillows they have found beneficial for their chronic pain. You can view their responses here.

Implement Good Sleep Hygiene

Sleep hygiene is defined as actions or habits that you practice regularly in order to improve your quality of sleep. Below are some sleep practices to incorporate into your bedtime routine:

  • • Create a dark space
  • • Develop a relaxing bedtime routine
  • • Avoid caffeine late at night
  • • Use ambient noise machines or devices
  • • When possible, don't nap during the day
  • • Get regular exercise
  • • Don’t eat fried, spicy, or citrus foods before sleep to avoid heart burn at night.

Find A Spine-Friendly Sleep Positing That Works For You

Start off by reviewing your current sleeping position. This can give you a better idea of what may be contributing to your discomfort as you sleep. When you wake up in the morning, before you move, take note of your position. Is your spine in a neutral, aligned position and supported? Is your neck in a healthy and comfortable position? Ask your partner or someone you trust to go over with you anything they have noticed about your sleeping position.

It is recommended that you at least try sleeping on your back flat with no pillow for some portion of the night. There is a plethora of benefits to sleeping on your back, including the alignment of your spine and decreased pressure.

If you can't sleep on your black flat, try lifting your knees a bit. You can put a thin pillow under your knees to hold them in that position, which will allow for better blood flow and keep your joints from locking up.

If unable to sleep without a pillow under your head, it is best to use a thin pillow. Thick or overstuffed pillows can put your neck in an unnatural position that can affect your posture during a prolonged period of sleep. If you can, try and eliminate your pillow altogether and sleep on the mattress directly.

Some people find that sleeping in a reclined position is more comfortable and the angle releases tension and pressure off the spine. Think about when you sit comfortably in your favorite chair. Are there ways that you can adjust that position slightly and make it a sleeping one?

Finally, whichever position you decide on, it's recommended that you avoid sleeping on your stomach. Doing so puts more pressure and stress on your neck and back, puts your head and spine out of alignment, and can increase tension, inflammation, and pain overtime.

Take your time to find the position that works best for you. Start off with the positions that are already working and tweak them slightly a little bit at a time to make them even better. Be aware that it could take several weeks or even months to find a position that's going to be best for your individual needs.

While there is currently no cure for spondyloarthritis and seeing a chiropractor for treatment is not recommended, as spinal manipulation can cause fractures in those with fusion, stretching, regular exercise, and working on finding a healthy and comfortable sleep position all help manage and reduce symptoms of spondyloarthritis.


About the Author


Dr. Brent Wells is a graduate of the University of Nevada where he earned his Bachelor's of Science degree before moving on to complete his Doctorate from Western States Chiropractic College. He founded Better Health Chiropractic & Physical Rehab in Alaska in 1998.

He became passionate about becoming a chiropractor after his own experiences with hurried, unprofessional healthcare providers. The goal for Dr. Wells is to treat his patients with care and compassion while providing them with a better quality of life.

Dr. Wells is a member of the American Chiropractic Association and the American Academy of Spine Physicians. He continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more.


Fatigue in chronic inflammation - a link to pain pathways. (2016). Retrieved October 22, 2018, from BioMedCentral:

How Much Sleep Do I Need? (2017, March 2). Retrieved October 22, 2018, from Centers for Disease Control and Prevention:
Spondyloarthritis: A Family of Related Diseases. (n.d.). Retrieved October 22, 2018, from Spondylitis Association of America:

What is sleep hygiene? (n.d.). Retrieved October 22, 2018, from National Sleep Foundation:
Zhou, X. (2015, December 3). Sleep well? Choose a right pillow! Retrieved October 22, 2018, from Sites at Penn State: allows you to rest, pain and stiffness can shake you back awake in the middle of the night.


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