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How to Sleep Better and Sit with Ankylosing Spondylitis

Ankylosing Spondylitis can make your lower back very stiff and achy.

When you sit too long, and when you sleep for many hours – the pain and discomfort get worse.

However, this pain aggravation can be prevented – without medication – if you learn how to sit properly and sleep comfortably during an AS flare.

In this post, you’ll find the best ways to sit and sleep without pain during an AS flare, and how to promote natural healing and pain prevention.

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What Does Ankylosing Spondylitis Pain Feel Like? 

Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting primarily the axial skeleton.

Usually, ankylosing spondylitis appears in the sacroiliac joints between the spine and pelvis, causing pain in the buttocks, hips, and lower back.

Symptoms of ankylosing spondylitis include pain and stiffness in the lower back and hips (usually in the morning and after sleep or after sitting for a few hours), neck pain, and fatigue.

Over time, symptoms may worsen, improve, or stop, triggered by activity, lifestyle, and how well you take care of yourself.

People with AS often describe an ongoing, dull pain that feels like it’s coming from deep within their lower back or buttocks, along with morning stiffness.

How Do You Sit Comfortably with Ankylosing Spondylitis?

To be able to sit comfortably during an AS flare, with the least amount of pain, you’ll need to sit in a way that keeps your spine straight and aligned.

If you work at home or at the office, you’ll need an ergonomic office chair that is adjustable, has lumbar support, a headrest, and optimally – a reclining option.

For example, one of the best office chairs for low back pain relief is the NOUHAUS 3D chair, which reclines up to 135 degrees, has a self-adjustable backrest, a good headrest, a waterfall seat, and arms that move in 4 directions.

See our full Nouhaus 3D review.

When you sit on your chair, make sure your tailbone touches the back of the chair, and your feet are flat on the floor.

Try to not lean forward while you work, or cross your legs.

As for a living room chair, a high-quality and adjustable recliner is the best type of chair for lower back pain.

According to studies, the best relaxing position for back pain relief is somewhat reclined, at 135 degrees, with lumbar support to keep your back aligned.

We found the top-rated living room chairs for back pain sufferers, with the best lumbar support and proper reclining options, here’s one of our recommendations:

The Da Vinci Piper Swivel recliner comes with a good lumbar support pillow, it reclines up to 130 degrees, the backrest is firm and spine-supporting, and the gliding mechanism is great.

Plus, we love the simple and classic design.

If you want to use your sitting time for some pain relief and healing, experts recommend using a heating pad over your lower back area.

A heating pad will not only relax your muscles and nerves but will also boost your blood circulation, which is important when you spend hours in a stagnant sitting position.

There are many types of heating pads available, from microwavable pillows to electric heating pads and infrared heating pads (deep penetrating) for the back, neck, and other joints.

Portable cordless heating pads are perfect for on-the-go use.

How to Sleep with Ankylosing Spondylitis

To sleep comfortably and pain-free, you’ll need a medium-firm mattress (preferably a hybrid mattress), the right orthopedic pillow for your sleep position, a cool and relaxing bedroom, and preferably some type of thermal therapy device.

What is the Best Mattress for Ankylosing Spondylitis?

According to the Spondylitis Association of America, “finding a balanced mattress that is somewhere between firm and soft is essential”.

The best mattress for AS would be a medium-firm mattress (a firm mattress is best but most people find it uncomfortable, which defeats the purpose), and the best type is a hybrid mattress for back pain.

A hybrid mattress is designed to be the best balance of comfort and spine support because it combines the pressure-relieving quality of memory foam and the bounce, support, and comfort of pocketed coils.

Innerspring mattresses often sag as they age—resulting in uneven sleeping surfaces, and are not recommended.

We found the Nolah Hybrid Mattress (image above) to be one of the best-value Hybrid mattresses for Ankylosing Spondylitis.

What is the Best Sleep Position for Ankylosing Spondylitis?

The Spondylitis Association of America recommends trying to sleep on your back flat with no pillow for at least a few hours during the night.

If you can’t, you can use a thin pillow (or a specialized pillow to keep you on your back) to reduce pressure and align your spine.

Some people find it comfortable to sleep on a recliner because the angle releases tension and pressure off the spine.

When you sit comfortably in your recliner, try to adjust the position slightly to make it a sleeping one and see how that works for you.

What is the Best Pillow for Ankylosing Spondylitis?

The best pillow for AS would be an orthopedic contoured pillow, which supports the neck and keeps it aligned with the rest of your spine.

For side sleeping, the best pillow is a contoured pillow (usually made from memory foam) which is firmer and higher, to fill the gap between the ear and outside shoulder thus keeping the spine aligned.

For stomach sleeping, the best pillow would be a soft, low-height pillow, to prevent the lifting of the cervical spine and reduce the twisting of the neck to a minimum.

However, it is recommended to avoid sleeping on your stomach.

According to studies, sleeping positions can affect and/or reflect the sleeping disturbances of people suffering from AS.

The best sleep position for back pain is back sleeping, but many people can not adjust to it, or find that it aggravates their snoring.

Many people find amazing relief in using a full body pillow, which replaces up to 4 different pillows in your bed (for example, a knee pillow to align the spine), and keeps your spine aligned when you wrap yourself around it throughout the night.

Heat Therapy for Ankylosing Spondylitis

Heat therapy is probably the most amazing natural treatment for acute pain (and many people have experienced long-term healing through it as well), and can easily be utilized before you go to sleep or while you are sleeping.

You can find a vast array of electric heating pads in all sizes and materials, that have an automatic shut-off or a timer and can quickly relieve back, neck, and AS hot spots.

You can comfortably fall asleep on them, knowing they will shut off automatically and prevent overheating or burning of your skin.

Heat therapy quickly boosts your blood circulation, allowing for a speedier arrival of oxygen, endorphins, and healing blood components, and is well known for being relaxing and sleep-inducing.

While infrared Jade heating pads are better and more effective, they are not comfortable enough to spend a whole night on, so we recommend a soft, plush electric heating pad.

Does Sitting Make AS Symptoms Worse?

Ankylosing spondylitis (AS) can make your back and neck stiff and achy.

According to most people, the pain can get worse if you sit for a long time.

The reason for this is that during prolonged sitting (or sleeping), inflammatory chemicals accumulate in the joints, which worsen the pain and stiffness.

This may cause waking up in the middle of the night with pain and feeling stiff and achy first thing in the morning.

Changing positions when you sit or sleep can be helpful.

More Ways to Relieve Ankylosing Spondylitis at Home & On the Go

There are many ways to relieve lower back pain from AS, that won’t take much of your time and can be utilized when you work, sit, sleep, or even do your chores.

For example, using heated massage therapy can be another layer of treatment you can benefit from. From full body massage mats to massage cushions and massage chairs, boosting your blood circulation is key to relaxing, boosting blood circulation, and healing.

Daily stretching also helps relax the muscles around your joints, allowing them to rejuvenate and heal. For example, a simple arched back stretcher is inexpensive, requires 5-10 minutes of treatment a day, and can be highly effective in the long term as well.

If you want a more powerful, mechanical stretch, consider getting a back traction home device.

A good wireless TENS machine eases the pain and can be used on the go, helping you get through the day when you simply have to move around.

To your health and happiness,

The Back Pain Relief Products Team 

Studies

Yolbas S, Yildirim A, Duzenci D, et al. Are Sleeping Positions Affect the Disease Activity of Ankylosing Spondylitis?
Annals of the Rheumatic Diseases 2014;73:1038.

Jones SD, Koh WH, Steiner A, Garrett SL, Calin A. Fatigue in ankylosing spondylitis: its prevalence and relationship to disease activity, sleep, and other factors. The Journal of Rheumatology. 1996 Mar;23(3):487-490. PMID: 8832988.