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Is Your Sleep Position Harming Your Health?

Back. Side. Stomach. Fetal. Which sleep position is healthiest?

As a chiropractic physician, this is a question I hear a lot. It’s also a question I love to address, given the importance of a good night’s rest to peoples’ overall health and happiness.

So what’s the answer? It really depends on your preferences and a variety of health-related considerations. It’s easier to start with what most experts agree is the worst position—the stomach. Read on to learn why and what to consider as you choose sleep positions, your bed, pillows, and alternatives counting sheep.

Better Sleeping Tips

Why consider changing your sleep position?

If you’ve ever woken up with a stiff neck, you understand the short-term impact of a poor sleep position. Symptoms, which are typically caused by muscles straining to protect joints in response to an awkward neck position, include pain and discomfort that is often intense and can linger for days. It’s your body’s way of telling you something was not right.

If you frequently wake up feeling stiff and sore, there is a chance that it may be related to negative muscle and joint adaptations to your sleep position, and a good indicator that you should reconsider how you are sleeping. Neck pain, low back pain, headaches, muscle and joint problems may all be caused or worsened by an inappropriate sleep position or even sleeping in the same position all of the time.

The good news? If you believe that your sleep position is causing you problems, the fix is free. You simply need to adjust your habits over time.

What you need to know about the four main sleep positions

Most people sleep on their back, side, stomach or in the fetal position, so let’s look at the good and the bad of each position.

1 – Back

The good: According to natural health expert Joseph Mercola, an osteopathic physician, sleeping on your back may be one of the most beneficial sleep positions, as it keeps your head, neck, and spine aligned, minimizes your acid reflux symptoms, and may prevent facial wrinkles.

The bad: The main drawback is a greater chance you will snore, which can lead to more serious health issues, if you have sleep apnea.

Tip: For optimal structural health benefits when sleeping on your back, consider setting your pillow aside or using a cervical roll (a small cylindrical pillow) that provides support for your neck without elevating your head. When sleeping on your back, your face should be parallel to the ceiling, not tilted up or down.

2 – Side

The good: Sleeping on your side may help prevent spine-related pain and minimize the symptoms of acid reflux. When you have a good mattress for your body shape, side sleeping helps keep your spine in a relatively neutral position, which may help reduce or prevent back and neck pain or discomfort. Sleeping on your side may also help reduce or prevent snoring.

The bad: Nerve compression and muscle tightness in your shoulders and neck are two possible musculoskeletal problems associated with side sleeping.

Tip: Use a pillow that holds your neck in a neutral, aligned position. The pillow should be the thickness of your shoulder and should hold your head in such as way that it is neither elevated or depressed compared to your spine. Also consider placing a second pillow between your knees in order to keep your hips open (similar to their normal position while standing). A knee pillow can help reduce low back pain as well as the strain on your sacroiliac ligaments in your hips and is particularly beneficial for pregnant women. Side sleeping, especially sleeping on your left side, is the recommended sleeping position for pregnant women.

3 – Fetal

The good: While the fetal position may help reduce snoring and is acceptable for pregnant women, it is generally not advised for most people.

The bad: Keeping your body and spine tightly curled in the fetal position can lead to muscle and ligament adaptations that contribute to neck, back and hip pain.

Tip: Avoid the fetal position as much as possible, unless you are pregnant.

4 – Stomach

The good: Significantly reduced snoring may be the only benefit of sleeping on your stomach

The bad: Most experts agree that stomach sleeping is best avoided because it alters the natural curve of your lower spine, or lumbar. It may also negatively affect your neck by stressing joints and muscles, and contributing to numbness, tingling, and pain in your extremities.

Tip: If you prefer sleeping on your stomach, try to shift positions several times in the night and gradually reduce the amount of time you spend on your stomach (ideally until you avoid the position altogether).

What you need to know about choosing a bed

Without the right bed for your body type, you may have trouble getting into and maintaining a healthy sleeping position. For example, if a bed is too hard to allow your hips to sink down so your spine is straight (neutral) when you choose to sleep on your side, then sleeping on your side will not only be uncomfortable but it could be bad for your back. So while mattress choice is a personal preference, remember:

  • Find the right level of support: A surface that is firm enough to distribute your weight comfortably while maintaining proper curve in your lower back (so if you feel like your hips are sagging or raised while you are on your side, keep looking)
  • Give it time: It’s hard to tell how comfortable a mattress is going to be until you’ve spent some time on it. So once you narrow down your choices, try to devote at least 15 – 20 minutes lying in your preferred position on your top choice to see if you notice any pressure spots.

What you need to know about pillows

Did you know? Your pillow choice can have profound effects on your sleep comfort and quality.

Choosing the right pillow

If you prefer side sleeping, find a pillow that is thick enough to fill the entire gap between your neck and your mattress, as this will keep your head and neck in a neutral position and reduce the strain on your neck ligaments, muscles, and other connective tissues.

When sleeping on your back, consider avoiding pillows altogether or just using a thin, soft pillow to support your head.

If you regularly switch from your side to your back, it can be hard to find a pillow that’s ideal for both positions, but there are options available so try to find one that works for you, keeping in mind the points above about keeping you neck neutral while you sleep.

Still counting sheep? Don’t forget…

A good sleep position can help you sleep more comfortably and keep you healthier, but rejuvenating sleep is about more than position. You also need to consider your other sleep habits, or hygiene, to get quality sleep. So if you’re not waking up rested, try these tips:

  • Reduce or eliminate daytime naps
  • Stick to a regular bedtime and wake-up time
  • Avoid alcohol and caffeine before bed (for as much as 4 to 6 hours, depending on your body’s response to them)
  • Establish a pre bedtime ritual
  • Block out all loud noises and lights from your bedroom (especially device and TV screens)
  • Set a comfortable bedroom temperature 

If you are in the Portland (OR) area and have questions about sleep positions or want to schedule an appointment, we’re here to help. Our goal is to give you a chance to improve your health. Call us now at (503) 227-2279.