Spinal degeneration can induce pain at night or upon awakening, but this condition will persist in daylight hours as well. Individuals who experience back pain only after sleeping probably have chronic problems with their posture or sleep environments instead. Secondary causes of pain in the back, shoulders and neck may include stress and anxiety that create muscle tension and encourage a tightly curled sleeping position.
The National Sleep Foundation reports that late-night exercise as well as ingesting snacks, caffeine, nicotine or alcohol shortly before sleep can also have negative effects. Primary causes of painful sleep may have more to do with poor sleep posture.
Many people use mattresses that sag and throw the spine, neck and head out of alignment. While other people err on the opposite side of caution by buying a mattress that is too firm. Either extreme can cause chronic back pain. The Cleveland Clinic notes that body type remains the criterion for choosing mattress firmness, and points out that sleep partners may have different needs.
Softer, but not sagging, mattresses best accommodate people whose waists are narrower than their hips. These mattresses aid sleep posture by absorbing greater pelvic weight. Individuals whose hips and waists are of equal proportions can benefit by firmer, but not hard, mattresses.
The American Physical Therapy Association relates that correct sleep posture depends upon a pillow that supports the natural cervical, or neck, curve of the spine. Multiple or overstuffed pillows can contribute to back pain and should not be used. Regular feather, fiberfill and foam pillows break down over time, and can cause an onset of back and neck pain.
Replacing pillows regularly or selecting pillows made of special materials, such as refillable water pillows or those made from viscoelastic, or memory, foam promote good sleeping positions. Pillows that are thinner in the center and thicker on the ends are designed for cervical support of both back and side sleepers.
If back pain incidents prove isolated, they may result from an occasional stomach sleeping position. The American Chiropractic Association discourages this sleep posture that places stress on each of the spine's three natural curves, lumbar, thoracic and cervical.
Side sleeping can create a pelvic tilt that induces pain, and back sleeping can stress the lumbar spinal region. The ACA suggests avoiding these risks by placing a pillow between the knees when side sleeping and under the knees when sleeping on the back.