Kickas.org Forums Ankylosing Spondylitis General Discussion Helpful Tips Question on tips for sleeping well

Hi,
I am wondering whether anyone can help me with this. I just found out that I have AS, but I've been having terrible back pain (you know, the kind that wakes you up, but goes away during the day) for years on and off. I thought that I discovered the solution when I bought a sleep number bed and set the setting to very soft. This allowed me to sleep without any pain for quite a while. I know that the pain comes back when I sleep on firmer mattresses, because I always suffer when I fall asleep with my kids. Here are my questions:

1. Now that I know I have AS, I have read that I should be sleeping on a firmer mattress. I have taken the sleep number from 30 to 70, but of course I am waking up very early in a lot of pain. Should I continue to sleep on the firmer mattress or just sleep whichever way doesn't cause me any pain?

2. I know that I should be sleeping on my back and not my side...but when I wake up in pain, there is no way that I can stay on my back. So, I first try to go onto my stomach for a few minutes (as long as I can stand it) and then end up on my side again. This seems to be the only way I can get back to sleep. I know that I probably shouldn't be doing this - but don't know what else to do.

3. My back pain always seems to act up when I go on vacation. This is probably because up to now, any mattress that I slept on while away would have been much firmer than my own mattress. I just returned and my back pain is quite bad. Should I be taking an advil before bed? I've been on the NSD for a month and haven't had any other joints involved since then, but the back is still very sore. I'd rather not take any medication at all, but I'm wondering IS THE INFLAMMATION IN THE BACK THAT I UNDERSTAND WILL CAUSE THE BONES TO FUSE WORSE THAN TAKING THE ADVIL OR NAPROXEN OR WHATEVER? I'm not sure whether I should just wait out the pain until it goes away again or take something before going to bed?

Thanks for your help.

taking a zanaflex each night has helped me a lot.
it lowers my blood pressure and causes me to fall asleep.
and the lower muscle tone helps me stay asleep most nights.
and it only lasts for 6 hours so doesn't affect waking up and being alert in the morning.

when things are very bad, i go to bed with an icepack as well for where ever is most inflamed. sometimes i'll take a hot water bottle to bed as well to help balance out the cold.

and sometimes my heated mattress pad helps, but its important that i turn it either off or very low after the bed is warmed up as i think the heat increases my inflammation.

and if things are bad enough, a bath or shower right before bed is also helpful....during very bad times i'll take another shower in the middle of the night as well, to help get me back to sleep.

i sleep on my back, with pillows under my legs to position my pelvis better, but not so my knees are bent. having my knees too bent in the past made my hamstring tendon entheses behind my knees flare very badly, but if i make sure my legs are flat up on the pillows, the hamstring tendons usually stay settled down much better.

and i use a very thin feather pillow for under my head; really more to fill in the space under my neck with a little bit of cushioning under my head. the most important thing for me is that my neck is completely neutral when i sleep. tilted forward flares it, turned to either side flares it. i have bone spurs in my facet joints and believe this is why.

my opinion is to sleep however you are most comfortable and listen to your body. some of us need harder mattresses, some softer, i think its highly personal. i need something in the middle: too soft and my muscles spasm in response but too too hard is not good either. for me firm but with a little bit of softness is best, but that's just me.

i sleep on my back because either side irritates my SI joint right away and my shoulders and ribs as well. i used to be a side sleeper until i developed the inflammatory arthritis. and the front, with the head turned to either side kills my neck, so that is out. i sleep the way i do simply because it seems best for my body.

i've always just listened to my body; i believe it never lies. if i were you, i'd find the most comfy sleeping position on the most comfy bed and just do that, if it were me. as that is essentially what i've done over the years.

thanks for the reply Sue. I am just worried that if I continue to sleep on my side and if I continue to sleep on a very soft mattress, I might have relief from pain but will ultimately be encouraging the curvature in my spine. Perhaps if I do this, I will eventually have worse pain? The AS Patient Guidebook seems to tell us to sleep on a firm mattress and on our back - so just not sure if I should follow the instructions or what my body most wants?

i'm not sure, maybe your doctor would know.

i've always kind of thought that (for me) pain (in the joints, tendons, etc) = inflammation and inflammation = bad. and thus have let my pain dictate what i should do. i don't know if that's true or not, but its always the assumption that i made.

it may only be partially true, for example, they say that we often bend forward to try to relieve some of the back pain but then end up bent forward which is not good.

interesting question.

My doctor told me, and my own research agreed, keeping the spine straight is very important, because if you fuse it is much easier to continue normal activities with and upright posture. Sleeping hunched, slouching, things like this can attribute to fusing with curvature.

It's recommended to be comfortable so that you can get much needed rest, but to use pillows and positioning that keep your spine aligned.

[link removed]

Exercise and Posture

Keeping Straight Through the Night

Hopefully you'll find some tips there that help you stay comfortable and straight.

thanks so much for these links...very helpful!

One further question. These articles say not to put a pillow under your feet and the last one says not to have one under your knees. Does anyone know why? I thought that having a small pillow under the knees (so they are not too bent) actually helps align the spine. It seems more comfortable to me. What have you heard?

I have heard many people here say they use a small pillow under the knees. I don't, but not sure why it isn't recommended.

Sometimes when sitting on the bed with my lappie, I put a pillow under my knees, because my lower back is very dipped. I'm a swayback mare LOL. It truly is uncomfortable, and the pillow really helps. But as I've gotten my bed all situated now where I don't roll to my side too often, I generally wake up like a 'back to sleep' baby. LOL

wendy warned on here about how it can mess up the knees. i slept with pillow under knees propped pretty high and bow-legged to relax where the IT / TFL bands attach to the trochanter; otherwise it would become more inflamed (tore it).

after a year of sleeping like that, the IT / TFL trochanter attachment (enthesis) was better, but its probably what caused the hamstring tendonitis (enthesitis) where it attaches behind the knees. still even now, years later, sometimes it flares.

like you, i have to have something to help "tilt" my pelvis when i sleep. now i put two pillows not on top of one another, but next to each other, elevate my legs but not bent at the knee. someone here warned (or maybe i read it elsewhere) that this will put pressure on the calves and cause some (circulatory?) problem; i'm not sure, but its the way i sleep for now.

on while on my back.......