How to Sleep With Sciatica: 3 Positions for a Restful Night’s Sleep

Written by Kristen Gasnick, PT, DPT | Reviewed by Sanjai Sinha, MDPublished on April 3, 2023

Key takeaways:

• Sciatica causes low back pain that travels down to the leg, which can make it hard to fall or stay asleep.
• Learning how to sleep with sciatica means keeping your hips and spine properly aligned. Sleeping on your side with a pillow between your knees or on your back with a pillow under your knees may ease low back pain.
• Strategies, like gentle stretching and heat therapy, can also help you sleep better with sciatica.

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Sciatica causes low back pain that travels down the leg. It can range from mild to severe, making it hard to get a restful night’s sleep. But expert tips can help you learn how to sleep with sciatica, including the best positions to make it easier and more comfortable.

What are the best positions to sleep with sciatica?

Sciatica occurs when the sciatic nerve is irritated or compressed. Your sciatic nerve — the largest one in your body — starts at the low back. It continues down the back of the leg to the knee, where it splits into the tibial and common peroneal nerves.

Pain and other symptoms along the sciatic nerve — like numbness, tingling, or weakness — can make it hard to fall or stay asleep. And certain positions may increase pressure on the sciatic nerve, worsening your symptoms.

The best sleeping position for sciatica depends on your symptoms and personal preferences. But ideally, you should find a position that keeps your hips and spine aligned. Consider the following options to ease pressure on your sciatic nerve and help you get better sleep.

1. Sleep on your side with a pillow between your knees

Sleeping on your side with a pillow between your knees tends to be comfortable for many people with sciatica or other types of back pain. This sleep posture may lessen low back pain or discomfort. The pillow at your knees is key for proper spinal alignment. Without it, you might twist your spine and make sciatica symptoms worse.

1. Lie on your side with your knees slightly bent. Keep your spine in a neutral position without bending or arching your back.
2. Place one or two pillows under your head to keep your neck neutral. Your head should stay aligned with your neck and spine. Add or remove a pillow if your head bends too far down toward the bed or too far up toward the ceiling.
3. Place a pillow between your knees to keep your hips, knees, and ankles stacked on top of each other. If you have wider hips, you may need to use two pillows.

2. Sleep in the fetal position

The fetal position is another side-lying option for people with sciatica. This curled-up position opens up the spaces between your spine. It can help alleviate sciatic nerve pressure, especially if you have spinal stenosis.

1. Lie on your side with one or two pillows under your head.
2. Round your trunk forward, bending your knees toward your belly.
3. Place a pillow between your knees if needed. You can also hug a body pillow to help keep you in a fetal position.

3. Sleep on your back with a pillow under your knees

Sleeping face-up on your back helps keep your weight evenly distributed. But sometimes, this position can strain your lower back. To avoid this, try placing a pillow under your knees to ease pressure on your spine.

1. Lie on your back. Place a pillow under your head to support your neck.
2. Place a pillow under your knees to lift your legs and support the natural curve of your spine. This will prevent pulling on your lower back.
3. You can also put a pillow under your lower back for extra support.

Alternatives for sciatica pain relief before bed

Changing your sleeping position isn’t the only thing you can do to sleep better with sciatica. Try these at-home methods to help relieve sciatic nerve pain before bed:

• Apply ice or heat. Using an ice pack or heating pad on your lower back can help limit pain and relieve muscle tightness.
• Take OTC pain relievers short term. A short course of OTC pain medicine may ease your symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve) can temporarily limit pain and inflammation.
• Find a supportive mattress. A mattress that is either too soft or too hard won’t offer proper support for your spine. A scientific review suggests that a medium-firm mattress is best to support your back when you sleep.
• Do gentle stretches and exercises. Stretching your lower back and hip muscles may help lessen tension on the sciatic nerve. Core-strengthening exercises can also help stabilize your spine and limit sciatica symptoms.
• Steer clear of activities that make your pain worse. High-impact exercises — like running and heavy weightlifting — can worsen sciatica. Choose gentler movements, like walking and swimming.
• Take a warm bath or shower before bed. A 2019 review suggests that a warm bath or shower may improve sleep quality by lowering your core body temperature. It can also help relieve tight muscles and stiff joints.

The bottom line

Sciatic nerve pain in your lower back and legs doesn’t have to keep you up at night. Certain sleep postures may help. The best sleeping positions for sciatica — like on your side in a fetal position or with a pillow between your knees — should support the natural curve of your spine.

When you find a comfortable option, it may even alleviate some of your symptoms. If you have ongoing nerve pain, talk to your healthcare provider about treatment options and how to sleep with sciatica.