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How to Sleep Better with Sciatica Pain

If you have sciatica pain, you know it can have a lot of impact on your day-to-day quality of life. It can be chronic throughout the day, and it’s fairly common for it to worsen at night. That’s why it’s important to learn how to sleep with sciatica and pick up some healthy habits that will help you get a good night’s rest. 

If you’re reading this, then you’re already looking for answers. And, while I can’t promise your sciatica will completely go away, there are a few recommendations that will at least reduce the pain. 

Depending on how severe your discomfort, these tips and tricks may have a profound effect on your sleep quality. But first, we want to make sure that sciatica is truly the culprit for your hip pain while sleeping.

Is sciatica the cause of your hip pain at night?

Sciatica pain is a nerve-related condition that a large percentage of adults experience at some point in their lives. It can cause nerve pain extending through the glutes, legs, shins, and feet. 

While there are a few probable causes of sciatica pain, one tight and overlooked muscle group that often contributes to sciatica pain is the iliopsoas muscles (also known as the hip flexors).


The iliopsoas is made up of two muscles, the iliacus and the psoas. When these muscles are tight, the lower back goes into rotation, side-bending, and extension. This tugs on the piriformis muscle in the center of your glute (where the sciatica nerve passes through). As this muscle tightens, it can pinch the nerve and even cause sacroiliac joint pain.



Many times, when people experience sciatica pain, they try to treat the source or the area of the pain. While this is not a bad tactic, and it can reduce pain for a time, it is alway better to discover the root cause of your sciatica pain.

The root cause of sciatica pain may be tight hip flexor and piriformis muscles, which can be easily addressed! So this article will cover both immediate fixes for getting sleep tonight and ways to reduce sciatica pain long-term.

Sciatica can sometimes be confused with lower back pain, but they are much different conditions. If you’re not sure, some common symptoms for people experiencing sciatica include: 

  • Muscle weakness in one or both of your feet and legs. 
  • Numbness in one or both of your legs. 
  • Sharp or shooting pain that travels from your lower back all the way to your foot. 
  • A “pins and needles” type sensation in your legs extending down to your feet and toes. 

The exact area of the pain will not be the same for all people with sciatica because it will depend on where the nerve is impacted and the direct cause of the pain. 

No matter the cause, there is a commonality: sciatica can impact your sleep. 

Discovering the root cause of your pain is a good long-term goal, but you still need to know how to sleep with sciatica and how to manage your symptoms.

How to sleep with sciatica pain 

Many people that have sciatica find that their pain may increase when they try to go to sleep at night. This is usually because the location of the nerve that is impacted is now under more pressure when you are lying down, especially on your side. The increased pressure can irritate the nerve even more depending on the type of mattress you have - or your favorite sleeping position. 

Since pain often extends beyond the specific pain or trigger point and extends down the leg, this becomes increasingly difficult. 

Whatever the cause, the suggestions for getting a better night’s sleep will be the same. So, when learning how to sleep with sciatica, those are the two things you should do first.

1. Adjust your sleeping position


When learning how to sleep with sciatica, your sleeping position can impact your level of pain drastically. For instance, sleeping with sciatica becomes more difficult when your back is arched or curves more towards the mattress. This may be because you sleep on your stomach, or your mattress is too soft so your spine curves, adding pressure to the lower back and sciatica nerve. 

There are many sleeping positions that can minimize hip pain when sleeping and help you learn how to sleep with sciatica pain. 

If you do have sciatica pain or hip pain at night, then one of the best positions to sleep in is on your side with a pillow between your legs. Sleeping on your side with sciatica reduces the pressure put on the nerve. 

Most people have sciatica pain that is isolated to one side of their body, so learning how to sleep with sciatica pain may involve sleeping with that side on top to avoid any unnecessary pressure on the nerve. 

Just remember, alignment is still key!

Adding a pillow lengthwise between your knees and ankles in this position will help to put your hips in a more neutral position. The pillow will lift your knee up slightly to make it more aligned with your hip, taking some of the pull off of the hip muscles while you sleep. 

Another sleep position that tends to help many people with sciatica is sleeping on your back with a pillow under your knees. While sleeping on your back may increase the pressure on your nerve, it can also help distribute some of the weight across your back. 

Adding a pillow under your knees helps to relax your hip flexor muscles (which you now know may be part of the problem). You may need to put more than one pillow under your knees to get the relief you need when learning how to sleep with sciatica. Experimenting with the height of the pillow and deciding how much to bend your knees is important.

Sleeping with sciatica pain will look a little different for everyone, so trying out a few sleeping positions for hip pain may be necessary to find the one that works for you.

2. Consider a new mattress 

I’ve already mentioned that the type of mattress you have can impact how to sleep with sciatica pain. The cause of your sciatica and the severity of the pain can certainly impact this, but there are some mattress types that can help minimize your pain. 

As a general rule, softer surfaces cause more curvature in your spine, which adds more pressure to the nerve. Some people with sciatica pain actually choose to sleep on the floor because it keeps their spine in proper alignment. 

When learning how to sleep with sciatica, you might try laying down a camping pad or a yoga mat. This generally works for most people that have severe sciatica pain. 

If sleeping on the floor doesn’t seem like the ideal solution, there are other options!

Seek out a medium-firm mattress. This should help improve your spinal alignment and reduce your sciatica pain. 

If you don’t want to invest in a new mattress or sleep on the floor, still another possible way to learn how to sleep with sciatica is to firm up the current mattress you have. This is easily done by slipping a piece of plywood under the mattress but on top of the box spring. 

The firmness you prefer will likely be different from another person with sciatica pain, and if you sleep in the same bed as your partner, they may not like the mattress to be so firm. So, for many people, effectively reducing and managing their pain could be a combination of a few different strategies. 

Solutions for sleeping better with sciatica pain

Finally, having a long-term solution to comfortably sleep with sciatica nerve pain or hip pain at night often has to extend beyond the type of mattress you have or the sleeping position that you prefer. 

If iliopsoas muscle tightness is contributing to your sciatica pain, addressing the tension and tightness in those muscles will help you get your pelvis back into alignment. The piriformis muscle will also begin to relax as the iliopsoas releases more, and both of these things open up more space for the nerve.


It may take some time to do this, but over time, the nerve will have enough room to heal and prevent pain in your leg. 

Releasing the iliopsoas can be difficult, especially without the help of a physical therapist. That’s why I invented the Hip Hook. This muscle release tool applies prolonged pressure to both the psoas muscle and the hard-to-reach iliacus muscle, providing the direct pressure required to finally release those muscle knots.

This muscle release can be done in as little as 10 minutes each night before bed. 

With or without the Hip Hook, you can build a bedtime routine that reduces some of your sciatica or hip pain at night. 

Doing things like yoga or stretching before bed can loosen up your muscles and help relax your body in preparation for sleep. Similarly, taking a warm bath may relax your muscles some. 

You may also want to try to integrate self massage for sciatica before bed. This can easily be done in correlation with the Hip Hook, and I encourage you to release both the front and back of your hip for best results. Self massage for sciatica can be done using a lacrosse ball, or the Hip Flexor Release Ball

In the end, how to sleep with sciatica nerve pain becomes a somewhat personal experience. Find out what works for you, and invest in long-term solutions for your body.

The important thing to remember is that sciatica pain and hip pain can be managed and even be reversed depending on the cause of your pain. One of the best ways to manage any type of pain that is interfering with your sleep is to create good bedtime habits and routines, and take the time during the day to truly care for your body to prevent pain in the first place!

FAQs about Sleeping with Sciatica

Why is sciatica pain worse at night?

When you lay down, muscle tension is creating a tug-of-war on your hip joints: your hip flexors in front and your piriformis in back. Your sciatic nerve runs alongside and underneath these muscles, and can become impinged by muscle tension and pelvis misalignment.

What is the best position to sleep in with sciatica?

There are ways to get comfortable in a variety of sleeping positions with sciatica, with the right angle and pillows! If you’re a side sleeper with sciatica, adding a pillow lengthwise between your knees and ankles in this position will help to put your hips in a more neutral position. If you’re a back sleeper with sciatica, adding a pillow or two under your knees can help by relaxing the position of your hip flexors.

How does the piriformis affect sciatica?

The sciatic nerve runs through or under the piriformis muscle. When this muscle is tight, it can impinge upon the sciatic nerve. Tension in the piriformis can be caused or worsened by tension in the iliopsoas muscle, your primary hip flexors.

By Christine Koth . Thu Jul 22

Author Bio

Uncovering the cause of your pain is my mission. As a bestselling author and holistic physical therapist with decades of experience, I have helped countless people, just like you, recover from long-standing issues. I've discovered a major cause of pain hidden in the hip and this has lead to my "Iliacus Queen" and hip expert status. I'm here to help you discover causes like this. It doesn't have to be complicated to live a pain-free life. We can do this. I look forward to supporting you on your healing journey.