Are Your Sleep Habits Hurting Your Back? A Spinal Surgeon Shares What To Change

If you wake up each morning with back stiffness or discomfort, the cause may not be the stress of daily life — it could be how you sleep.

According to Dr. Gbolohan Okubadejo, a New York City-area spinal and orthopedic surgeon, poor sleep posture and unsupportive sleep surfaces can prevent your back from getting the recovery it needs overnight.

“Your back should recover during sleep,” says Okubadejo. “But incorrect mattresses, pillows or sleep positions can lead to ongoing back strain instead of restful recovery. You can achieve better spinal health and minimize back pain through minor adjustments in your sleep environment and practices.”

Some sleep positions naturally support spinal alignment, while others can cause strain on muscles and joints. Okubadejo says sleeping on your back is ideal for spinal health, especially with a small pillow under the knees to support the lower backs natural curve.

Next best, according to Okubadejo, would be side sleeping, with a supportive pillow and a second pillow between the knees, which can also maintain spinal alignment and ease pressure points.

Sleeping on your stomach is considered the least healthy position for your spine, as it twists the neck and strains the back, Okubadejo says. If you cant sleep any other way, use a flat pillow or none at all and place a cushion under your hips.

Mattress choice plays a major role in spinal alignment and sleep quality. Okubadejo says a medium-firm mattress offers the best balance between comfort and support, avoiding the sink-in feeling of softer beds and the pressure points caused by very firm ones.

When it comes to choosing between memory foam or hybrid mattresses, Okubadejo says memory foam conforms to the bodys contours, which can help relieve pressure, while hybrid mattresses combine supportive coils with foam comfort, which can help spinal alignment.

Mattresses generally last 7–10 years, and it’s important to replace them when needed. If yours is sagging or you wake up sore, it may be time for a new mattress.

Pillows, meanwhile, do more than support the head — they help maintain alignment from head to spine.

Back sleepers should look for a pillow that supports the necks natural curve. Side sleepers need a firm pillow to bridge the gap between the ear and shoulder, plus a knee pillow for hip support. Stomach sleepers should use a thin pillow or none at all to prevent neck strain.

Okubadejo recommends sticking to a consistent sleep schedule, which helps keep the body in sync, especially muscles and joints. He says light stretching or yoga before bed can help prevent stiffness in the morning, and a cool, quiet, and dark bedroom can help ensure a deeper, more restorative sleep. Turning off screens at least an hour before sleep to reduce blue light exposure can also help.

If your back pain persists despite adjusting your sleep environment, consult a specialist.

“Sleep is when your body is supposed to heal,” says Okubadejo. “When your mattress and pillows support your spine the right way, youll feel the difference — less pain, better movement, and more energy. Sometimes small changes lead to big improvements.”