How to Sleep with Scoliosis: Essential Tips

September 7, 2023 | Casper Editorial Team

Fact checked by Jonathan Eilenberg, CPE

When it comes to sleeping with scoliosis, sleep on your back or side, and avoid sleeping on your stomach. Sleep on a high-quality, medium-firm mattress, and consider using specialized scoliosis pillows for maximum comfort.

What Is Scoliosis?

Scoliosis is a condition in which the spine curves abnormally to the side in an S-shape or C-shape. This spinal curvature cannot be corrected simply by posture or positioning. Instead, the vertebrae are rotated, which pulls the spine into a sideways curve, sometimes manifesting in visible scoliosis symptoms.1

Scoliosis can develop at any age, but it most often begins just before puberty. As adolescents go through growth spurts, sometimes their spines grow at uneven rates, leading to curvature. While the specific cause is often unknown, factors like genetics, certain neuromuscular conditions, and abnormalities present at birth can increase the risk.2

The abnormal curvature caused by scoliosis is permanent. It will not go away on its own.3 However, early treatment is key to preventing the curve from progressing and minimizing long-term impacts on health.

How Scoliosis Affects the Body and Sleep

As the spine curves to the side, the ribs on one side of the body will begin to protrude and create a rotating effect. This can lead to visible asymmetry with one shoulder or hip higher than the other. The pelvis can also tilt and rotate, causing leg length differences.4

This abnormal curvature also commonly causes chronic back pain as it puts strain on the muscles and joints, leading to both back and neck pain. The protruding ribs can affect lung capacity as well, leading to shortness of breath and impaired breathing.5

All of these effects of scoliosis can significantly impact sleep quality. The back pain and discomfort make it very difficult to fall and stay asleep comfortably. Tossing and turning while trying to find pain relief exacerbates the pain and fatigue. Impaired breathing during sleep, called sleep apnea, also diminishes sleep quality. Learn about the worst and best sleeping positions for sleep apnea today.

Poor sleep quality and disrupted sleep worsens the scoliosis pain and exhaustion that comes with it. It’s a vicious cycle. This makes getting quality, restorative sleep a top priority for scoliosis patients.

The Importance of Good Sleep for Scoliosis Patients

Sleep is when the body does most of its healing and regeneration. Growth hormones are secreted to facilitate tissue growth and repair. The hormones melatonin and serotonin are also released to help reduce inflammation and naturally decrease pain.6

A good night’s sleep is crucial for growing adolescents to support their development. During certain sleep stages, memories are also consolidated and cognition sharpened.7

Improved sleep quality sets scoliosis patients up to feel more energized to take on the day. Their focus, balance, and coordination for daily activities are also improved after a restful night. Finding sleep positions and solutions that allow people with scoliosis to sleep through the night is key to optimizing health and function.

Best Sleeping Positions for Scoliosis

Sleeping on Your Back: The Optimal Sleep Position

Sleeping on the back keeps the full spine elongated, rather than bent or twisted. This neutral position helps minimize pain and progression of the scoliotic curve.8 Having the right mattress that supports this position is essential to ensure pressure relief and optimal comfort.

As a back sleeper, it’s ideal to fully lie flat without any pillows propping up the head or knees — placing pillows under the knees can actually twist the lower spine and pelvis. Alternatively, a lumbar or thin thoracic pillow can be used to provide support where there’s abnormal curvature. When it comes to how to sleep on your back, simply extend your legs long with toes pointed up. Place your arms at your sides, and avoid crossing them which can put strain on your shoulder.

Benefits of Using Cervical Pillows

A very thin cervical pillow can help fill the natural space beneath the neck for those who feel most comfortable with this slight support. Choose a curved cervical pillow specifically contoured to cradle the neck rather than lift it up. These types of pillows prevent any neck pain and strain.

Cervical pillows also come in different densities and firmnesses. Try different options to find the one that feels most comfortable and supportive for your body.

Sleeping on Your Side: The Next Best Option

If back sleeping is uncomfortable, side sleeping is the next best sleeping position option to reduce rotational pressure on the spine versus lying face down.8 Draw one knee up towards your chest and place a small pillow between your knees.

The Role of Pillows Between the Knees

With scoliosis, the upper section of the spine may tilt one way while the lower tilts the other way. Placing a pillow between the knees prevents the upper hip/spine from twisting forward and the lower spine/hip from twisting backward during side sleeping. This placement is key to maintaining a neutral spinal alignment and minimizing stress on the scoliotic curve.8

The pillow thickness should allow your hips and knees to stay stacked on top of each other rather than splaying open or squeezing together. Pay attention to any pulls or tensions you feel, particularly at your hips and waist, and adjust the support pillow accordingly until both your upper and lower spine feel relaxed.

Why Stomach Sleeping is Highly Discouraged

Sorry, stomach sleepers, but sleeping face down is problematic for spinal health in general. With scoliosis, stomach sleeping is especially discouraged due to the increased torsion it puts on the spine.8

The head must be turned to the side to allow breathing room when stomach sleeping. This twists the neck awkwardly. Simultaneously, the natural arch of the back hyperextends as the pelvis sinks into the mattress. This strains the muscles along the entire spine.9

Stomach sleeping applies rotational forces that exacerbate the abnormal side-to-side spinal curvatures of scoliosis. For this reason, it is highly recommended to avoid stomach sleeping altogether for those living with scoliosis. Back or side sleep positions are much preferable.

Addressing Sleep Discomforts Caused by Scoliosis

The Role of Customized Scoliosis Pillows

Well-designed pillows customized for scoliosis can help reduce pain and improve restfulness when sleeping. Ideal scoliosis pillows have contours that follow the natural asymmetry of the shoulders and waist caused by the rotated spine.

This customized shape accommodates the protruding ribs and raised shoulders on one side to reduce tension build up. It also fills the space between the mattress and waist to prevent sinking. Overall, the improved spinal alignment and cushioning minimizes discomfort when side sleeping.

Some scoliosis pillows also have a cutaway center designed to accommodate face down breathing. This can help alleviate feelings of breathlessness that scoliosis patients often experience, especially when sleeping on the concave side of the spine’s rotation.10

The Importance of a Supportive Mattress

Sleeping with the right mattress is also key to reducing pain and enhancing sleep quality for scoliosis patients. A too orthopedic mattress allows sagging and twisting of the body which strains the spine. But an overly rigid mattress lacks cushioning and can aggravate pressure points.

Features to Consider: Firmness, Temperature Regulation, and Pressure Points

Look for a high quality medium firm mattress that gently supports the natural contours and curves of the body without sagging. This provides a comfortable and neutral alignment for the spine.

Since night sweats are a common issue with chronic pain conditions, cooling gels infused in a memory foam mattress along with breathable mattress covers help regulate temperature for a comfortable sleep climate all night long.

Zoned support with strategically placed softer and firmer foams relieves pressure points in the shoulders, hips, and along the spine by contouring to those specific body areas while keeping the spine straight.

You can find all of these features within our line of bed mattresses. Read our guide for our top choices for the best mattress for scoliosis and find relief today.

Proactive Treatment and Scoliosis Management

Corrective Bracing: A Solution for Nighttime

Wearing a corrective back brace at night can help gently guide the spine into a straighter position over time and prevent the scoliotic curve from worsening. Through consistent nightly use, the spine may move towards a more normalized alignment and reduce pain.11

However, the rigid plastic or hard material of these braces can be uncomfortable for long periods of sleep. Cushioning pads for areas like beneath the arm openings help. A mattress topper can also make bracing more tolerable and prevent skin irritation.

The Role of Proactive Treatment in Improving Sleep

Along with bracing, proactive treatment like physical therapy and strength training helps manage scoliosis-related pain.12 By keeping the core and back muscles strong and flexible, sleep is less disrupted by discomfort. This allows patients to fall asleep more easily and sink into deeper, more restorative sleep.

Regular exercise also helps minimize pain signals being sent to the brain so they do not interfere with sleep. Being physically active during the day, or even trying yoga for sleep, results in more sound sleep at night.

Addressing Scoliosis-Related Lung Impairment

The rotated position of the ribs caused by scoliosis reduces expandability of the lungs.5 This decreased lung capacity leads to impaired breathing which diminishes sleep quality.

Practicing breathing techniques during the day can help strengthen the diaphragm and rib muscles to expand lung capacity. Breathing exercises are also recommended before bed to maximize oxygenation potential during sleep.13

Specialized deep breathing pillows with cutouts reduce pressure on the ribs. This allows for abdominal breathing to fully fill the lungs when sleeping. Supportive pillow positioning is key to optimizing comfort and unrestrained breathing.

Casper Mattresses: Your Partner in Achieving Restful Sleep

Casper mattresses provide the ideal comfort, support, and cooling scoliosis patients need for reduced nighttime pain and improved sleep quality.

Our Zoned Support system has softer foam by the shoulders and firmer foam by the hips and waist. This eases pressure on the protruding ribs while gently supporting the spine into proper alignment.

Perforations in the foam along with cooling gel pods infused into the mattress absorb and dissipate body heat. This AirScape technology regulates temperature and reduces night sweats.

With flexible financing options, free no-contact delivery, and a 100-night trial period, Casper ensures your complete satisfaction. Investing in better sleep is priceless when living with scoliosis. Casper wants to be your sleep-health partner on the journey towards rested and rejuvenating nights.


  1. Mayo Clinic Staff. Scoliosis – Symptoms and causes. Mayo Clinic. Published 2017. 
  2. NIAMS. NIAMS Health Information on Scoliosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published March 2019. 
  3. Cluett J. Scoliosis: An Abnormal Curvature of the Spine. Verywell Health. Published March 8, 2023. 
  4. Scoliosis in Children and Teens. NIH.
  5. Koumbourlis AC. Scoliosis and the respiratory system. Paediatric Respiratory Reviews. 2006;7(2):152-160. doi: 
  6. Irwin MR. Why Sleep Is Important for Health: A Psychoneuroimmunology Perspective. Annual Review of Psychology. 2015;66(1):143-172. doi: 
  7. Paller KA, Creery JD, Schechtman E. Memory and Sleep: How Sleep Cognition Can Change the Waking Mind for the Better. Annual Review of Psychology. 2021;72(1):123-150. doi: 
  8. Nalda T. How to Sleep with Scoliosis. Scoliosis Reduction Center. Published May 19, 2020. 
  9. scoliosisptjax. Sleeping Positions. ScoliosisPTJax. Published October 18, 2022. 
  10. Foster J. The 16 Best Pillows for Scoliosis Relief of 2023 [Verified]. Cherry Picks. Published August 20, 2022. 
  11. Yrjönen T, Ylikoski M, Schlenzka D, Kinnunen R, Poussa M. Effectiveness of the Providence nighttime bracing in adolescent idiopathic scoliosis: a comparative study of 36 female patients. European Spine Journal. 2006;15(7):1139-1143. doi: 
  12. Berdishevsky H, Lebel VA, Bettany-Saltikov J, et al. Physiotherapy scoliosis-specific exercises – a comprehensive review of seven major schools. Scoliosis and Spinal Disorders. 2016;11(1). doi: 
  13. Cleveland Clinic. Diaphragmatic breathing exercises & techniques. Cleveland Clinic. Published 2019.

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Casper blog articles are written by skilled authors and periodically reviewed by our team of sleep experts at Casper Labs. Driven by comprehensive research and evidence-based practices, we ensure that the content we publish is reliable, actionable, and practical for enhancing sleep quality and wellness.

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