Sleeping with back pain may be caused by ankylosing spondylitis, strenuous exercise, muscle strains and other reasons. 1. Ankylosing spondylitis: it is a chronic progressive inflammation of the spine, the cause of which may be related to genetics, infection and other reasons. Due to the stimulation of inflammation, patients may also experience back pain while sleeping. 2. Strenuous exercise: when the patient after strenuous exercise, the lower back can appear a large number of lactic acid accumulation, so the patient can appear to sleep back pain phenomenon. Common exercises include sit-ups and jumping exercises. 3. Muscle strain: It may be due to improper preparatory activities, poor muscle elasticity and strength, and injuries caused by sharp contraction or excessive pulling during exercise. When the patient lumbar back muscle strain, can also appear to sleep back pain phenomenon. It is recommended that patients with back pain go to the hospital in time, do relevant examinations to clarify the cause of the disease, and then follow the doctor’s instructions for treatment to avoid delaying the condition.