Sleep Apnea and Back Pain: What’s the Connection?

Back pain and sleep problems often make each other worse for many adults. Sleep apnea, a common issue in the US, affects around 26% of adults aged 30-70 and can make back pain worse. Studies show that about 59% of people with back pain also have trouble sleeping, especially if their pain is bad.

Sleep apnea not only messes with sleep but also causes inflammation and problems with muscles and bones, like disc issues and fractures, which can make back pain worse.

In this article, we’ll explore the connection between sleep apnea and back pain, and help you find suitable treatments to live a pain-free life.

What is Sleep Apnea?

Sleep Apnea and Back Pain

Sleep apnea is a sleep disorder characterized by repeated interruptions in breathing during sleep. These interruptions, known as apneas, can occur due to a physical blockage of the airway (obstructive sleep apnea, OSA) or a failure in the brain’s signal to breathe (central sleep apnea, CSA).

People with sleep apnea often experience reduced oxygen levels during sleep, frequent awakenings, and a disruption of the sleep cycle, which prevents restful sleep.

What’s the Connection Between Sleep Apnea and Back Pain?

The connection between sleep apnea and back pain is multifaceted, involving both physiological and mechanical factors that can exacerbate each other.

Sleep apnea often leads to poor sleep quality, which can increase the body’s sensitivity to pain. This is due to disruptions in the body’s natural pain modulation systems. When sleep is fragmented or non-restorative, it can increase your perception of pain, including back pain.

Sleep apnea is also associated with increased systemic inflammation. During sleep apnea, you’ll experience repeated cycles of low oxygen levels and subsequent reoxygenation. This might lead to oxidative stress and contribute to degenerative changes in the spine. 

To alleviate symptoms of sleep apnea, people often adopt certain sleeping positions. These positions can put additional strain on the spine, leading to or worsening back pain. For example, side sleeping can cause misalignment of the spine and hips, which places extra stress on the back. 

Research has shown that people with sleep apnea may have a higher prevalence of spinal abnormalities such as disc bulges and spondylosis. These conditions can be both a cause and a consequence of sleep apnea, as they may alter the structure of the airway and contribute to the apnea itself. 

Treatment for Back Pain and Sleep Apnea

Sleep apnea and back pain are usually treated with a combination of medical interventions and lifestyle changes. When you treat both conditions together, you’ll have better health outcomes and a better quality of life. Here are some effective strategies:

Medical Treatments

  • Positive Airway Pressure Devices: Continuous Positive Airway Pressure (CPAP) machines are the most common treatment for sleep apnea. They help keep the airway open during sleep, which can improve sleep quality and reduce the symptoms of sleep apnea, potentially alleviating associated back pain.
  • Oral Appliances: For those who cannot tolerate CPAP, oral appliances designed to keep the airway open by positioning the jaw or tongue may be an alternative. These devices can also help reduce sleep apnea symptoms and improve sleep quality, which may indirectly help alleviate back pain.
  • Surgical Options: In severe cases of sleep apnea, surgical interventions such as upper airway surgery may be considered. These surgeries can help reduce the anatomical obstructions causing sleep apnea. While not directly treating back pain, improving sleep apnea can reduce the chronic pain experience.

Lifestyle Modifications

  • Weight Management: Obesity is a significant risk factor for both sleep apnea and back pain. Weight loss through diet and exercise can reduce the severity of sleep apnea and relieve the stress on the back, thereby reducing pain.
  • Exercise: Regular physical activity can strengthen the muscles supporting the back and improve overall body mechanics. Exercise also helps in weight management and can improve sleep apnea symptoms.
  • Sleeping Positions: Adjusting sleeping positions can benefit both conditions. Sleeping on the side with a pillow between the knees can help maintain spinal alignment and reduce back pain, while also helping keep the airway open to address sleep apnea.
  • Avoid Harmful Substances: Reducing or eliminating the intake of alcohol and avoiding sedative medications before bedtime can decrease the severity of sleep apnea symptoms. Alcohol relaxes throat muscles, exacerbating both sleep apnea and potentially leading to poor sleep positions that can cause back pain.
  • Quit Smoking: Smoking can increase inflammation and worsen both sleep apnea and back pain. Quitting smoking is recommended to help manage these conditions.


1. Is there a connection between back pain and sleep apnea?

Yes, back pain and sleep apnea are connected. Sleep apnea can lead to poor sleep quality, which may exacerbate chronic pain conditions like back pain. Moreover, inflammation caused by sleep apnea can contribute to musculoskeletal pain.

2. Can a sleep disorder cause back pain?

Yes, sleep disorders like insomnia and restless leg syndrome can aggravate back pain. Poor sleeping positions and inadequate pillows or mattresses can also strain the spine at night, leading to increased discomfort in the morning.

3. Can sleep apnea cause muscle aches and pains?

Yes, because sleep apnea disrupts sleep patterns, it causes insufficient restorative sleep that causes muscle aches and pains. The low oxygen levels in the blood during episodes of obstructive sleep apnea can also make muscles sore.

4. Can sleep apnea cause inflammation in the body?

Yes, studies show that untreated obstructive sleep apnea (OSA) contributes significantly to systemic inflammation. This occurs because OSA leads to oxidative stress on cells due to repeated hypoxia-reoxygenation cycles throughout each night.

Need professional help to diagnose and address your sleep problems? Schedule an online consultation with sleep specialist Dr. John Williams.

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