Relationship Between Sleep Posture and Low Back Pain: A Systematic Review

Area of Science:

• Orthopedics
• Sleep Medicine
• Rehabilitation Science

Background:

• Low back pain (LBP) is a prevalent condition affecting millions globally.
• Sleep posture is a modifiable factor potentially influencing LBP symptoms.

Purpose of the Study:

• To systematically review the association between various sleeping postures (supine, prone, side-lying, variable) and low back pain.
• To determine how sleeping positions affect LBP prevalence, symptom aggravation, or alleviation.

Main Methods:

• Systematic review following PRISMA guidelines with a pre-registered protocol (PROSPERO ID: CRD42024628738).
• Searched PubMed, Scopus, and ScienceDirect for observational studies (2005-2024) on sleeping posture and LBP.
• Assessed study quality and risk of bias using the NIH Quality Assessment Tool.

Main Results:

• The supine position promotes spinal alignment and is linked to lower LBP prevalence.
• Prone sleeping increases LBP risk due to potential lumbar strain.
• Side-lying posture's effect on LBP depends on spinal alignment; supportive alignment reduces pain, while poor alignment exacerbates it. Variable positions showed minimal LBP association.

Conclusions:

• Supine and supportive side-lying postures are recommended for managing low back pain and improving spinal health.
• Prone sleeping is associated with increased LBP and should be avoided.
• Ergonomic interventions, including appropriate bedding and posture education, are suggested for LBP management.