Preferences and Avoidance of Sleeping Positions Among Patients With Chronic Low Back Pain: A Cross-Sectional Study.
Level 4 - case-series / case-control
Cross-sectional survey of clinical patients
PubMed 38846227 · doi:10.7759/cureus.59772
What was done
A cross-sectional study evaluated 375 consecutive adult outpatients referred for specialist consultation for nonspecific chronic low back pain (CLBP) at a Finnish hospital spine clinic. Pain intensity was evaluated using a visual analog scale (VAS) and disability using the Oswestry Disability Index (ODI). Patients completed questionnaires detailing their main sleeping positions, positions avoided due to back pain, and sleep or morning rising difficulties.
What was found
Among 375 patients (mean age 51 ± 17 years, 64% female, mean VAS 63 ± 24, mean ODI 38 ± 18%): - Primary sleeping positions reported: side-lying (87%, n=327), supine (47%, n=176), and prone (22%, n=82). - Positions avoided due to pain: prone (42%, n=157), supine (35%, n=131), left side (15%, n=56), and right side (13%, n=49). - Prone preference negatively correlated with age. Gender differences in sleeping positions were non-significant (p=0.69). - Sleep was disturbed by low back pain in 77% (n=289) of patients, 87% (n=327) had difficulty getting up in the morning, and 92% (n=345) experienced sleep or morning rising difficulties.
Why it matters
Although prone sleeping is the posture most frequently avoided by patients with chronic low back pain, pain exacerbations occur across all positions. Sleep posture recommendations should be individualized rather than prescriptive.
Limits
The study is cross-sectional and cannot determine whether sleep positions cause or result from back pain. Sleep positions and disruptions were self-reported without objective posture tracking or sleep monitoring. The sample was restricted to a single specialized spine clinic.
Cited by
- supports Sleeping on the stomach puts extra pressure on the lower back and can cause low back pain over time.