Break the Cycle of Back Pain and Poor Sleep

Back pain and insomnia (difficulty falling asleep or waking too often or early) can easily become a frustrating cycle with one leading into the other. Read on to learn more about this cycle—and how to break it for good.

6 min read
Woman with her eyes closed and massaging her forehead.

We can all agree that back pain doesn’t feel good. And if back pain is keeping you up at night, it can make you feel even worse! Plus, lack of sleep can throw a big wrench into your overall health and well-being.

Back pain and insomnia (difficulty falling asleep or waking too often or early) can easily become a frustrating cycle with one leading into the other. The good news is that it’s totally possible to break the Back Pain–Insomnia Cycle. Read on to learn more about this cycle—and how to break it for good.

The Back Pain–Insomnia Cycle

Many people with back pain struggle to get a proper night’s sleep.[1-3] What’s more, insomnia doesn’t discriminate when it comes to the type of back pain you have. In other words, sleep can suffer with short-term (acute) or long-term (chronic) back pain. So whether your back pain makes a brief appearance or long overstays its welcome, you might find yourself tossing and turning at night.

As we mentioned at the beginning, back pain and poor sleep are closely related, with each contributing to the other. Back pain can cause insomnia, and insomnia, in turn, can actually make back pain worse.[4-7 ] This feedback loop is otherwise known as the Back Pain–Insomnia Cycle.

Illustration of man with lower back pain next to a woman with insomnia.
The Back Pain–Insomnia Cycle

In addition to the obvious discomfort, here are some other reasons why back pain can keep you up at night:

  • When you lie in a darkened bedroom at night without daytime distractions, your mind tends to tune in to pain more
  • People with chronic back pain may have more frequent, intense periods of lighter-stage sleep. This can lead to waking up more often during the night.[4]
  • Inflammation (related to back pain and/or other conditions like arthritis or sinusitis) can also contribute to poor sleep[8,9]

How Back Pain–Related Insomnia Affects the Mind and Body

If you’ve ever had a bout of insomnia, you’ve probably noticed how it can affect different areas of your life and your overall well-being. When back pain is the culprit for poor sleep, you may notice difficulties with your physical functioning, mood, energy level—and even your outlook.[4,7] Over time, poor sleep can lead to other health issues, such as lowered immunity and foggy or impaired thinking.[4] That’s why it’s important to address back pain and insomnia early on before they snowball into more serious health issues.[5]

It’s a fact: getting plenty of rest is always important for physical, emotional, and mental well-being. With back pain, it’s even more important to get good sleep as part of your back health plan. In addition to getting your zzz’s, the National Institutes of Health recommends exercise and progressive relaxation to deal with back pain.[10] The Kaia Pain app offers both physical exercises and relaxation practices (including progressive relaxation) to help you manage your back pain.

Healthy Sleep Tips

What are some ways to break the vicious Back Pain–Insomnia Cycle and get some much-needed rest? In addition to directly addressing your back pain, we recommend sticking to the following healthy sleep tips:

🔵 Tip #1: Have consistent sleep/wake times (even on weekends!). This helps you to set a solid sleep-wake cycle.[11]

🔵 Tip #2: Relax before bedtime. This is a great time to do the relaxation exercises in your Kaia Pain app. Or, do light stretching, meditate, enjoy light reading, or have a small snack before bed. This will encourage your mind and body to unwind.[11]

🔵 Tip #3: Prep your bedroom for sleep. Keep the temperature comfortable (not too warm) and eliminate light and sound as much as possible. Make sure your mattress and pillows are in good condition and adequately support your body. (Nix any old pancake-flat pillows!)[11]

🔵 Tip #4: Power down devices at least 30 minutes before bedtime. Light from your laptop and phone screen can rev your brain up when it should really be winding down.[12] Let your brain know it’s shut-eye time by turning devices off at least a half-hour before bed.[11]

🔵 Tip #5: Use sleep positions recommended for back pain. Whether you’re a side, back, or stomach sleeper, there’s a supportive sleep position for everyone. The Mayo Clinic recommends the following sleep positions to help with back pain[13]:

Side—Draw your legs up slightly to your chest and put a pillow between your legs. Put a pillow under your head.

Back—Put a pillow under your knees, a small rolled towel under the curve of your back, and a pillow under your head

Stomach—Put a pillow under your pelvis. If it doesn’t strain the back, slide a pillow under your head, too. (If this causes back strain, try sleeping without a head pillow.)


Back pain and poor sleep can create a frustrating cycle with each one perpetuating the other. Also, poor sleep can lead to other health issues and decreased overall well-being. That’s why it’s important to break the cycle early by tackling both back pain and insomnia head-on.

The Kaia Pain app provides physical exercises and relaxation practices to help you stretch and strengthen your body, as well as calm your mind. This can help you to both manage back pain and rest easier. In addition to addressing back pain directly, it’s also a good idea to practice healthy sleep habits. Bringing your back health and sleep into balance can make a world of difference in your quality of life. So start making changes today!


  1. Alsaadi SM, McAuley JH, Hush JM, Maher CG. Prevalence of sleep disturbance in patients with low back pain. Eur Spine J. 2011;20(5):737-743.
  2. Uchmanowicz I, Kołtuniuk A, Stępień A, Uchmanowicz B, Rosińczuk J. The influence of sleep disorders on the quality of life in patients with chronic low back pain. Scand J Caring Sci. 2019;33(1):119-127.
  3. Bahouq H, Allali F, Rkain H, Hmamouchi I, Hajjaj-Hassouni N. Prevalence and severity of insomnia in chronic low back pain patients. Rheumatol Int. 2013;33(5):1277-1281.
  4. Deardorff WW. Chronic pain and insomnia: breaking the cycle. SPINE-health website. Accessed April 26, 2019.
  5. Purushothaman B, Singh A, Lingutla K, Bhatia C, Pollock R, Krishna M. Prevalence of insomnia in patients with chronic back pain. J Orthop Surg (Hong Kong). 2013;21(1):68-70.
  6. Schrimpf M, Liegl G, Boeckle M, Leitner A, Geisler P, Pieh C. The effect of sleep deprivation on pain perception in healthy subjects: a meta-analysis. Sleep Med. 2015;16(11):1313-1320.
  7. Gerhart JI, Burns JW, Post KM, et al. Relationships between sleep quality and pain-related factors for people with chronic low back pain: tests of reciprocal and time of day effects. Ann Behav Med. 2017;51(3):365-375.
  8. Wilson D. How inflammation and pain affect your sleep. Dr. Doni website. Accessed April 29, 2019.
  9. Raison CL, Rye DB, Woolwine BJ, et al. Chronic interferon-alpha administration disrupts sleep continuity and depth in patients with hepatitis C: association with fatigue, motor slowing and increased evening cortisol. Biol Psychiatry. 2010;68(10):942-949.
  10. National Institutes of Health, National Institute of Neurological Disorders and Stroke. Low back pain fact sheet. Accessed April 29, 2019.
  11. Healthy sleep tips. website. Updated July 30, 2020. Accessed September 22, 2020.
  12. Grandner MA, Gallagher RA, Gooneratne NS. The use of technology at night: impact on sleep and health. J Clin Sleep Med. 2013;9(12):1301-1302.
  13. Mayo Clinic. Slide show: sleeping positions that reduce back pain. Accessed April 29, 2019.

Further Reading