Dr. Pham Hoang Hai, from the Department of Musculoskeletal Internal Medicine at Tam Anh General Hospital, Ho Chi Minh City, notes that ankylosing spondylitis symptoms, such as back pain and joint stiffness, often worsen during periods of immobility or prolonged rest, especially during and after sleep. Many patients experience disturbed sleep, waking frequently at night as pain and stiffness typically intensify from midnight towards morning.

Adopting correct sleeping postures offers a supportive measure to alleviate symptoms. However, if patients consistently wake due to nighttime back pain, experience persistent morning stiffness, or notice worsening symptoms, a medical re-evaluation and timely adjustments are crucial.

Beyond adjusting sleeping positions, modifying mattresses or pillows can reduce spinal pressure, limit discomfort, and improve sleep quality for patients.

Dr. Hai explains test results to a patient. *Tam Anh General Hospital*

Dr. Hai highlights several appropriate sleeping positions for patients.

Sleeping on your back maintains the spine in a neutral position, evenly distributing body weight and minimizing pressure on the vertebrae. For added support, placing a thin pillow under the knees is beneficial. This position helps preserve the lumbar spine's physiological curve, reduces lower back muscle tension, and prevents morning pain.

Side-lying with a pillow between the legs balances the pelvis, prevents inward hip rotation, and lessens pressure on the sacroiliac joint and lumbar region. When in this position, patients should keep their body aligned from head to hips, avoiding excessive knee flexion towards the chest. Incorrect side-lying can increase muscle contracture and negatively impact the spine's natural curve.

Dr. Hai emphasizes that mattresses and pillows significantly influence sleeping posture effectiveness. An overly soft mattress allows deep body sinking, while an overly firm one creates pressure points on the shoulders, hips, and back. An ideal mattress offers moderate firmness, providing sufficient support to maintain a neutral spinal position while contouring to the body's natural curves.

Patients should select pillows appropriate for their sleeping position. Back sleepers generally prefer thin pillows, whereas side sleepers may need thicker ones to bridge the gap between the head and shoulder.

Correct sleeping positions help reduce nighttime back pain and joint stiffness, improving sleep quality. *Ngoc Pham*

Dr. Hai advises that beyond adjusting sleeping positions, individuals with ankylosing spondylitis must adhere to their prescribed treatment plan, take medication as directed, and attend regular follow-up appointments. Maintaining appropriate physical activity, including exercises like swimming, hanging from a bar, or spinal stretching under the guidance of a physical therapist, is also vital.

Patients should adopt a regular lifestyle, limit evening caffeine intake, eat light dinners not too late, and relax before bed. If the condition fails to improve, or if new symptoms such as loud snoring, daytime sleepiness, or sleep-related breathing difficulties emerge, early specialist consultation is necessary for prompt diagnosis and management.

Phi Hong