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Is Sleeping on the Floor Good for Your Back?

Is Sleeping on the Floor Good for Your Back?

Scientific American asked experts whether sleeping on a hard surface is actually beneficial for back pain

Senior woman laying flat on back on floor in bedroom at home

Koldunova_Anna/Getty Images

If lower back pain is keeping you up at night, you’re not alone: about one in three adults in the U.S. are affected by such aching, which often results in poor sleep. Western wellness influencers suggest that reclining on the floor could help. But is there any evidence to support the accolades given to floor sleeping?

The practice has a long history. For ages before ancient civilizations such as the Mesopotamians got the grand idea to rest on raised mattresses stuffed with reeds, humans got their Z’s while sprawled on the ground. Some of us still sleep this way—or close to it. Ayurveda, a holistic healing philosophy from India, extols floor sleeping as central to well-being, and many Japanese people sleep on a thin tatami mat on the ground.

It turns out that resting on the floor may offer advantages for certain people in certain scenarios. Some physiotherapists say that lying flat on your back in a star shape (with your arms and legs extending out and away from your torso) or with your knees up takes pressure off the back and can stretch it out. In addition, cooler temperatures near the floor may improve sleep quality and overall comfort, some experts say. Others agree that lying on the floor could have positive effects.

At least part of the benefit may be psychological. People sometimes learn to associate their bed with both insomnia and pain, says Deirdre Conroy, a clinical professor of psychiatry and clinical director of the Behavioral Sleep Medicine Clinic at the University of Michigan. At the clinic, Conroy has seen insomnia patients who would sleep better when they left their bed for other locations, including the floor. “The relief could be psychological,” she says.

The floor may feel especially good if you have an old box spring and saggy mattress. In these beds the pelvis sinks lower than the back because the pelvis area typically weighs more, bending the spine out of alignment. Compared with an overly soft mattress, “the floor could provide better support,” says Peter G. Whang, a professor in the department of orthopedics and rehabilitation at the Yale School of Medicine, who routinely treats patients with back pain.
如果您使用的是老式弹簧床和下垂的床垫,地板的感觉可能会特别好。在这些床上,骨盆下陷的位置比背部低,因为骨盆部位通常更重,会使脊柱弯曲变形。耶鲁大学医学院矫形与康复系教授 Peter G. Whang 说,与过于柔软的床垫相比,"地板可以提供更好的支撑"。

But most experts today agree that sleeping on the floor isn’t necessarily the best option for any type of back ailment, Whang says. The main reason is that the shape of the human spine differs significantly from that of the floor; our spine isn’t board-straight. “We have physiologic curves,” Whang says. One such curve leaves space between the lower back and the floor. Lacking support, this curve flattens out over time, which can result in back pain. Another problem with the floor: without cushioning to absorb the shoulders, the upper back is often propped up too high, which can lead to joint stiffness.
但如今大多数专家都认为,睡在地板上并不一定是任何类型背部疾病的最佳选择,Whang 说。主要原因是人体脊柱的形状与地板有很大不同;我们的脊柱并不是笔直的。"我们有生理曲线,"Whang 说。其中一个曲线在下背部和地面之间留有空间。缺乏支撑,随着时间的推移,这种曲线会逐渐变平,从而导致背部疼痛。地板的另一个问题是:如果没有缓冲装置来吸收肩部的压力,上背部往往会被撑得过高,从而导致关节僵硬。

A hard floor also creates pressure points in places such as your hips, buttocks and heels, says Bert Jacobson, a kinesiology professor at Oklahoma State University. This can restrict blood flow to those areas and potentially damage soft tissue.
俄克拉荷马州立大学(Oklahoma State University)运动学教授伯特-雅各布森(Bert Jacobson)说,硬地板还会在臀部、臀部和脚后跟等部位形成压力点。这会限制这些部位的血液流动,并可能损伤软组织。

So how did our ancestors maintain healthy backs while dreaming on the dirt for so many millennia? It’s true that “we did not evolve to sleep on soft, comfortable surfaces,” says Daniel Lieberman, a Harvard University professor, who studies evolutionary biology. But hunter-gatherers slept on the ground from early childhood and may have built up a tolerance to its ill effects, unlike present-day people who try it for the first time as adults. Another difference is that ancient people got more physical activity throughout the day, a lifestyle that may have helped prevent pain despite ground sleeping. And we should scrutinize arguments based only on what is natural, Lieberman warns, noting many examples of beneficial technologies that were unknown to our ancestors.
那么,千百年来,我们的祖先是如何在泥土上做梦的同时保持背部健康的呢?研究进化生物学的哈佛大学教授丹尼尔-利伯曼(Daniel Lieberman)说:"我们的确不是为了睡在柔软舒适的地面上而进化的。但狩猎采集者从小就睡在地面上,他们可能已经对地面的不良影响产生了耐受性,而不像现在的人在成年后才第一次尝试。另一个不同之处在于,古代人在一天当中有更多的体力活动,这种生活方式可能有助于预防疼痛,尽管他们睡在地上。利伯曼警告说,我们应该仔细研究仅以自然为基础的论点,他指出,有许多有益的技术是我们的祖先所不知道的。

Modern-day mattresses that provide new levels of support and comfort are one such example. In particular, across ages and body types, “medium-firm” mattresses tend to strike the right balance between hard floors and older, softer mattresses. Medium-firm mattresses work best to support the spine’s shape and to prevent back pain and resolve it, according to a review study published in 2021.
现代床垫提供了新的支撑力和舒适度,就是一个很好的例子。特别是,在不同年龄和体型的人群中,"中等硬度 "床垫往往能在硬地板和较旧的软床垫之间取得适当的平衡。根据 2021 年发表的一项回顾研究,中等硬度的床垫最能支撑脊柱的形状,并能预防和解决背痛问题。

If your back is giving you nightmares, the real solution could be replacing your worn-out mattress instead of descending to the floor. The average American’s bed is 10 years old, equating to about three years of sleep time. “No furniture in the world will sustain that type of weight and abuse,” Jacobson says. In one of his studies, a new, firmer mattress reduced back pain by 47 to 63 percent.
如果你的背部让你噩梦连连,真正的解决办法可能是更换破旧的床垫,而不是躺在地板上。美国人的床平均使用了 10 年,相当于三年的睡眠时间。"雅各布森说:"世界上没有任何家具可以承受这样的重量和滥用。在他的一项研究中,新的、更硬的床垫能将背痛减少 47% 至 63%。

But here’s the catch: scientists haven’t agreed on an objective standard for measuring firmness. Most sleep studies ask people to judge it subjectively, and you’ll have to do the same thing when looking for an ideal surface. One individual’s “medium-firm” may vary from another’s, partly because people who weigh more need a stiffer mattress to support them. “For a heavier person, their version of medium-firm will be firmer,” Jacobson says. For the same reason, they may even find the floor more comfortable than a petite person.
但问题是:科学家们尚未就衡量床垫硬度的客观标准达成一致。大多数睡眠研究都要求人们主观判断床垫的软硬度,而您在寻找理想床垫时也必须这样做。一个人的 "中等硬度 "可能与另一个人的 "中等硬度 "不同,部分原因是体重较大的人需要更硬的床垫来支撑。"雅各布森说:"对于体重较大的人来说,他们的中等硬度床垫会更硬一些。出于同样的原因,他们甚至会觉得地板比娇小的人更舒服。

More firmness could also benefit people who sleep on their side and stomach—although side sleeping on a firmer mattress may cause the lower spine to curve to the side in some cases, according to Jacobson. These firmer mattresses may not be ideal for back sleepers because their hips and upper torso will be raised higher than other parts of the body. Research is needed to confirm these hypotheses, Jacobson says. For the most comfort while lying on your back, the sleep surface should enable a position that resembles proper standing posture, something that is difficult to achieve on the floor.

If you’re not ready for a new mattress, a memory foam topper could help. “It really conforms to the spinal curve and keeps it aligned, regardless of your sleep position,” Jacobson says. This observation tracks with Whang’s experience at his clinic. “I’ve had many patients who really appreciate the memory foam mattress,” he says, adding that “mats and pillows composed of this material can be very good for the spine.”
如果您还没准备好换新床垫,记忆海绵床垫可以帮到您。"雅各布森说:"无论您的睡眠姿势如何,它都能真正贴合脊柱曲线,保持脊柱对齐。这一观点与 Whang 在诊所的经验不谋而合。"他说:"我的许多病人都非常喜欢记忆海绵床垫,"他补充说,"由这种材料制成的垫子和枕头对脊椎非常有益。

Finding the right sleeping surface, Whang points out, is just one piece of the puzzle for solving back pain. Other important factors include maintaining core strength, flexibility and a healthy weight. “We focus on prevention, not just the material you sleep on,” he says.
Whang 指出,找到合适的睡垫只是解决背痛问题的难题之一。其他重要因素包括保持核心力量、灵活性和健康体重。"他说:"我们注重的是预防,而不仅仅是你睡在什么材料上。