Interview with Michael Angelo, PT: Why Sleep Transitions Cause Pain

We sat down with the very experienced physical therapist Michael Angelo, the owner at Michael Angelo Physical Therapy and Wellness in Tucson, AZ , to talk about a problem many people struggle with - tossing and turning about leading to pain while rolling over or changing positions in bed.

In this conversation, he explains why movements during sleep often hurt more than lying still, how to set yourself up to minimise discomfort, and some practical tricks anyone can try tonight to minimise tossing and turning.

How To Stop Moving About In Bed

When it comes to sleep advice, most articles focus on the best position, whether that is on your back, side, or stomach. But what about the way we move in bed?

Could constant tossing and turning be one of the hidden reasons behind poor sleep?

I asked physical therapist Michael Angelo, who has spent years treating patients with pain and sleep-related issues, to share his perspective.

Why Movement Matters As Much As Position

“It’s really a combination of all those factors,” Michael explains. “In my practice, I’m very hands-on. People come in with tightness, knots, and soreness. We work those things out, but often they come back with the same problems. They find themselves in continuous patterns: waking up sore, struggling to stay asleep, or waking multiple times a night.”

According to Michael, it’s often not just the body that’s to blame. The sleep setup plays a huge role.

“When your pillow isn’t set up right, your sheets are uncomfortable, or your mattress is too soft or too firm, your body isn’t supported. You’ll toss and turn without even realising it. Even small amounts of tension can backfire over the long term. Setting yourself up in a tension-free position at the start of the night is key.”

Why Rolling Over Hurts

Turning over in bed should be a simple movement, but for many people it sparks sudden pain. I asked therapist Michael Angelo why rolling from side to side can feel so much worse than lying still.

“That’s a great question. At the very low part of your back are your SI joints, the sacroiliac joints, where your pelvis connects to your spine. Those joints only move about five millimetres. If they are inflamed or unstable, rolling can cause really sharp pain. That’s why so many people wake up when they roll.”

And it is not only the SI joints. “People also get mid-back or hip pain when rolling, but those joints are particularly sensitive. When they are not stabilised, rolling catches them and triggers pain almost every time.”

You Are Not Alone

Hearing this, I admitted, “I think I might have that!”

Michael smiled. “A lot of people do. Once you hit 30, almost everyone wakes up with back pain at some point.”

What Happens To Your Neck At Night

When we think about sleep pain, we often picture stiff backs or sore hips. But the neck and shoulders are just as vulnerable, especially when you move in the night.

I asked Michael Angelo to to explain why even small movements can cause such sharp pain.

“Those little joints in your neck are stacked very closely together,” Michael explains. “If your neck is slightly kinked and already inflamed, moving can pinch them more sharply. It is not a dull ache, it is aggressive.”

That pain does not always stay localised. “It can spread down into your shoulder blades. Your body then locks down muscles as a defense, but that creates even more pain. It becomes a cascade effect that often spreads to the mid-back, shoulders, and hips.”

How To Stop Moving So Much At Night

So what can you do to reduce tossing and turning?

“Ideally, I want you set up with so little tension that you don’t turn at all,” Michael says. “Most people think that’s impossible, but it can happen.”

The right pillow is key. “The Groove Pillow, which I use every night, helps keep your head and neck in the right position when you roll.

It is designed to contour without getting in your way, unlike big feather pillows. Even more important, if you feel even a slight pull or kink when you get into bed, adjust your pillow until you don’t. The goal is to eliminate tension so you are not fighting your body all night.”

Creating The Perfect Sleep Setup

I point that it seems like it's the full enviroment in our bedrooms we need to think about. “That is probably the big takeaway. It is not just the pillow, but also the mattress and even the sheets.”

Michael agrees. “Exactly. If your bedding is not right, you will toss and turn. Even climate matters, thin sheets in colder places, lighter cotton in warmer ones. Comfort matters because tension leads to more movement, and movement leads to pain.”

The 90-Second Bed Audit

Improving your sleep does not always require a big change. According to Michael Angelo, one of the simplest fixes takes less than two minutes. He calls it the 90-second bed audit.

What Is the 90-Second Bed Audit?

“It is just a quick check before bed,” Michael explains. “Take 90 seconds to make sure your pillow, sheets, and blankets are positioned correctly. Lie down and notice whether you feel tension in your neck, hips, or back. If you do, adjust. A towel under your waist or the right pillow between your legs can make a big difference.”

This short routine helps you identify pressure points before they turn into a night of tossing, turning, and morning pain.

Why Support Matters

So why do gaps under the waist, neck, or knees make sleep movements more painful?

“Because your spine is not designed to be unsupported,” Michael says. “Gaps cause your body to sag, which increases tension and pain. Over time, that pain takes longer to recover from. Supporting those gaps prevents that downward spiral.”

Simple Tools to Close the Gaps

When it comes to support, less is more.

“Flat supports like folded towels work well. I don’t want your spine bending over anything rounded, neutral support is the goal. For legs, the Groove X Pillow is great between your thighs.

Some people prefer using the original Groove Pillow between their legs for more support. Either way, filling the gap stops your knees from pulling your hips and back out of alignment.”

It seems to me like it all comes down to head-to-toe support.

Michael agrees. “It sounds like a lot, but really it’s just two pillows and a towel. Those little adjustments make a huge difference.”

Is Pain Really Just About Sleeping Position?

When it comes to sleep pain, most people assume it all comes down to whether you lie on your back, side, or stomach. But according to Michael Angelo, it is not that simple.

“Pain is complicated,” he explains. “Sleep setup is one part, but daily habits matter too. Stretching, posture, activity, hydration, and nutrition all play a role. Sleep is critical, but it is only one piece of overall musculoskeletal health.”

What To Do If Rolling Hurts

So what should you do if every time you roll at night you wake up sore?

Michael recommends starting with the 90-second bed audit to make sure your pillow, mattress, and bedding are all supporting you properly.

“If you are already inflamed, learn to roll correctly,” he says. “Instead of arching backward, roll in more of a crouched or fetal position. Bring your knee and shoulder forward together, almost like a crunch. That engages your core, braces your spine, and reduces pain.”

As I like to call it, it is “crunch and roll.”

Michael reassures us that most people can improve their sleep pain without spending a fortune. “Know that you are not alone. I hear about sleep pain every day. The key is small adjustments: a proper pillow, filling gaps, stretching, and moving with your core. You do not need to spend hundreds of pounds or dollars, just set yourself up for success with the right support.”

Where To Learn More

If you would like to follow Michael’s work, you can visit his website at michaelangeloptw.com or find him on Instagram at @michaelangeloptw.