Is there an ideal sleeping position?

Do you spend the whole night looking for it?

Your sleep position and your mattress provide support for the body while asleep. Sleep can be disturbed by any number of things – things we do during the day, things we do before retiring for the night, and things we do while we sleep. Sleeping position can sometimes aggravate our normal aches and pains and rouse us.

A number of functions can be affected by sleep position: stability of the spine, blood flow to the brain, hormone production, oxygen supply, efficient breathing, muscular function and healing, joint and ligament integrity, digestion, cellular metabolism, blood pressure and heart function. During the night, when there is no pressure on the spine, water is drawn into the discs to heal wear and tear.

The ways we sleep

Back: Sleeping on the back is recommended by many doctors. Your head, neck and spine can stay in a natural, neutral alignment meaning no extra pressure or curves are imposed on the back. This is the only time muscles at the back of your neck get to rest (otherwise, they’re working to support and move your head). Use a pillow that doesn’t raise your head too high; thick pillows interfere with normal spine alignment. Or go with no pillow at all and use a small foam roller or rolled-up hand towel under the neck to support the proper curve for this area.

The soldier position is similar to the yoga corpse pose: on your back, arms at your sides. Starfish position is a modification with your arms over your head. Starfish may exert pressure on nerves in the shoulder.

Side: Sleeping on your side is also highly recommended. This position helps those with neck or back pain. It elongates the spine, opening up the back. But lying with one shoulder directly under you can constrict arm and shoulder muscles and nerves.

Sleeping on your side seems to reduce the chance of waking during the night.

You’re in the log position when lying on one side with arms at your sides. This maintains the normal spinal curves and is comfortable for people with back pain, snorers, and pregnant women. This position requires a thicker pillow to provide proper head and neck support. The upper leg may fall forward while sleeping, though, twisting the spine and resulting in hip pain.

The yearner position is similar to the log, except your arms are in front of you. The advantages are those of the log position, but the arm position can put pressure on the shoulder and cause pain.

Fetal: Fetal position – lying on either side with chin down and knees drawn up – can put a strain on your neck and joints, especially when you curl up tightly. This position can lead to neck and back pain.

Stomach: Freefall position is lying on the stomach with arms overhead. Stomach sleeping is the least desirable sleeping position since it leads to overarching of the spine, increased pressure on the lungs, joints and muscles, and compromises circulation and breathing.

To be more comfortable lying on your stomach, lift one knee out to the side rather than keeping both legs straight.  Use no pillow under your head, and place a small, firm pillow under your hips. Optionally, add another pillow in any comfortable spot on the side you’ve raised your knee.

popular positions

Which way is the best way?

Each person usually tends toward one or two favorite sleeping positions. Proper support of spine integrity is vital, since the spinal cord is connected to every major body organ. Free flow of communication between the brain and the body needs to be maintained.

Sleeping on the back or on the side is usually recommended. Some sleep positions may be recommended for certain health conditions.

According to some experts, sleeping on the back is best, unless you snore.

Side sleeping is good for those who snore or have sleep apnea. To keep pressure off the bottom shoulder, either move that shoulder forward a bit, or extend the bottom arm straight out in front of you then use both arms to hug a pillow to your chest.

Holistic medicine calls the left side of the body the “dominant lymphatic side.” It is thought that toxins are filtered from lymph nodes more efficiently while lying on the left side.

Doctors often advise pregnant women to sleep on the left side to improve blood flow to the fetus as well as to internal organs.

Some experts recommend sleeping on the left side to relieve acid reflux; other experts say avoid sleeping on the left side to avoid constricting your liver, heart and lungs. Doctors sometimes caution people with heart problems to be careful about sleeping on their left side.

Side sleeping with knees drawn up toward the chest mimics the sitting position and may aggravate tight hip flexor muscles.

There is research suggesting that sleeping consistently on one side or the other may lead to kidney stones on the weight-bearing side. It can also inflame tissues on the weight-bearing side and result in soreness in the hip or trochanteric bursitis.

Curling up too tightly in fetal position restricts the diaphragm, affects breathing, and can leave you sore in the morning if you have arthritis in your back or joints.

Sleeping on the stomach has the most risk; it distorts the natural shape of the spine. It keeps your head turned to one side (resulting in nerve compression) and adds pressure on the stomach (which may exasperate acid reflux). Use of a pillow lengthwise, between the shoulders and the stomach, can help reduce overarching of the spine.

You might find the stomach position comfortable if you’ve had a heavy meal; it can keep stomach acid from backing up into the esophagus and reduce pain from heartburn. Snorers may benefit from this position since it keeps upper airways open.

Stomach sleeping for infants has been in and out of favor. There is some research showing that specific pressure points activated by lying on the belly are important in the development of nervous system programs in infants.

People with back pain may benefit from the Mayo Clinic’s recommendations. Sleep on your side with legs slightly drawn up, using a pillow between the legs. Or sleep on your back with a pillow under the knees and perhaps a small rolled up towel at the small of the back. Support the neck with the appropriate size pillow. If you sleep on your stomach use a pillow under the hips; use a pillow under the head only if it doesn’t put too much strain on the back.

The American Spine Group reports that sciatica sufferers may need a firmer mattress and extra pillow support for the head, shoulders and knees. The goal is keep the neck level with the spine – not above or below it. If you’re comfortable on your side, raise the top knee toward your head and support it with pillows to take pressure off the sciatic nerve. If side sleeping is not for you, try sleeping on your back with firm pillows under the knees; use enough pillow support to raise the knees above the hips to relieve pressure on the sciatic nerve.

Get help from props!

You will probably change sleep positions during the night. Look for ways to provide comfort in all of them. Pillows, foam rolls and rolled up hand towels can all help support you in a good night’s sleep.

Pillows can be used to support your neck, your back and joints. If your head pillow is too thin or too thick it can distort the natural curve of the spine and give you a stiff neck in the morning. Side sleepers, use a pillow between your knees. Back sleepers, try a small pillow under the small of your back as well as under your knees. Experiment with different sizes, different firmness. Surround yourself with pillows – create your own “pillow fort” to support your sleep position and keep you comfortable.

If your doctor recommends sleeping with your head or feet elevated, accomplish this by elevating one end of the bed itself; put blocks under the bed frame. Sleeping in a recliner may provide the desired elevation, but most recliners have little or no low back support.

Pressure exerted on any part of the body can disrupt sleep. Hammocks and zero-gravity chairs can provide comfort and eliminate pressure points.

The mattress should provide both cushioning and support. Changing your mattress every 7 years is recommended. Most mattresses degrade quickly after the first 2 years (and by then they’ve already sagged 25%). Mattresses break down most quickly in the area of greatest weight – our hips.

A degraded mattress is the greatest contributor to sleep-related back pain.

If you wake up after getting enough hours of sleep yet you don’t feel rested, it’s time to look at the quality of your sleep. Your sleep position needs to allow your body to function and recover as it should during the night. Varying your sleep positions during the night avoids putting constant pressure on the same area of the body, restricting blood flow and putting pressure on joints.

The healthiest or best sleep position is the one that lets you sleep soundly through the night.


The purpose of this site is educational. Nothing here is to be taken as diagnostic or as medical advice. Anyone with concerns about his/her health should consult the appropriate healthcare provider.


Stevenson, S.; Sleep Smarter; Rodale; New York, NY; 2016; ISBN: 978-1-62336-739-8


image: GraphicStock



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