What is the Best Position to Sleep In?
Some frequently asked questions we get in our Chiropractic office are patients asking, “What position should I sleep in?” “What is the best sleeping position for my spine alignment?” “If sleep the way I usually do, will that affect my spine alignment? Can I mess up my adjustment by sleeping on my stomach/back/side?”
These are all fantastic questions; we love when patients want to do the best for their health. Recommendations for sleep positions can be different depending on the person, so let’s break down each sleeping position and talk about some pros and cons and what chiropractors tend to recommend. Ideally we want you to get a good night’s sleep, and restful sleep at that, but depending on your body, you may want to try a few different sleeping positions to find what works best for you.
Side sleeping is, according to the Sleep Foundation, the most common sleep position, with 60% of people reporting that it is their preferred sleeping posture. Most chiropractors also agree that is the best sleep position and the most beneficial as it promotes healthy spinal alignment. It is the recommended sleep position for those with back pain as it allows the spine to sit in a neutral position without undue twisting or bad support. This position should be supported with pillows, sometimes behind the back or being hugged on the front (or both), and a supportive one under the head to help reduce neck pain. However, the most important pillow to help support this position is a pillow between the knees, which should be bent forward. That knee pillow helps keep the hips in a neutral position as well as helping the leg on top to not have to bend inward towards the bed which can cause tension in the pelvis and hip joints otherwise.
The only people who might prefer to not sleep on their side are those dealing with shoulder pain.
Those with acid reflux, people with back pain, people with position dependent snoring, pregnant women, and older people are recommended to sleep on their side over other sleeping positions as it helps prevent pain and soreness while helping your spine maintain proper alignment.
Sleeping on the left side is usually recommended as the most comfortable and beneficial side sleeping position. This is particularly recommended to those who are pregnant. For pregnant moms, sleeping on your side with knees bent, a pillow under your belly, in between your knees, and a pillow that matches the distance between the neck and shoulder can help relieve the pressure of a growing belly, and can also help the heart pump blood more easily through the body, facilitating healthy blood flow both through mom’s body, but also to baby.
Sleeping on the left side can also help reduce snoring, reduce symptoms of gastroesophageal reflux disease (GERD), and reduce acid reflux symptoms. It is also helpful for patients with obstructive sleep apnea as symptoms of that disorder are often more prevalent when sleeping on either your back or sides.
If the left side is uncomfortable for you to sleep in, the right side is also beneficial. Although Pregnant patients are recommended to sleep on the right over the left, there is not much difference between the sides. Sometimes people alter back and forth to help relieve pressure on the hip. Sleeping on the right side can, however, slightly increase the pressure on the internal organs, so it is often recommended to try on the left first.
The back sleeping position is often cited as the best position for those dealing with neck pain. This position helps keep the neck in it’s natural curve and can help prevent misalignment that can occur from twisting or rotating your neck while stomach sleeping, and it can stop you from leaning your neck to the side which can occur when side sleeping on an un-supportive pillow. When lying on your back, it is best to use a pillow that cradles your head and keeps it lying neutrally instead of jutted forward. This can help reduce and prevent neck pain. Alternatively, you can also roll up a towel under your neck to help with that natural curve, or use a flatter pillow.
Sleeping on your back can help drain your sinuses and alleviate pressure on the nasal and throat passages, so those dealing with congestion and wish to open their airways might want to try a back sleeping position.
However, back sleeping is not recommended for those who snore, people with sleep apnea, people with low back pain, those with GERD or acid reflux, as well as older or heavier adults.
Stomach sleeping is one of the least popular positions and most doctors and chiropractors alike agree that it is the worst sleeping position for the spine and neck. As you breathe at night, when on your stomach, your ribs are having to work against gravity to expand and contract, which can ultimately cause you to use more energy at night and can contribute to less restful sleep.
Sleeping on your stomach provides no support for the back and can contribute to low back pain, and being in a rotated neck position can invariably twist your neck and head out of alignment contributing to neck and back pain. This kind of asymmetrical sleeping position is not recommended.
However, some do find that sleeping on their side helps relieve symptoms of snoring and sleep apnea by helping keep their airways open and not collapsed.
It is possible to sleep well and healthily in this position. A very thin pillow or perhaps no pillow at all can stop you from tilting your neck up and back and relieve pressure on the spine. A firm mattress can also prevent you from sinking down and placing more stretching and unnecessary strain and tension on the body and spine.
But Which Should I Choose?
Ultimately, each sleeping position has different benefits and drawbacks. Although side sleeping is generally considered to be the the best sleep posture, we don’t want you to go and try new sleep positions if you are already in a comfy position and your sleep quality is good. However, if you are struggling with health problems and want to try a new position to help you sleep better, we always encourage it. We often tend to shift throughout the night anyway, and children tend to try different things every night. You will find what is comfortable for you.
What about Mattresses and Pillows?
Whatever position you sleep in, you want to ensure that your pillow supports your head. For side sleepers, the pillow should be firm enough to support your head and not keep your head bending towards the bed at an angle all night, and having a pillow to hug helps keep you from rolling, and a pillow between the knees supports the hips and keeps them level. For a back sleeper, a pillow that cradles the neck while not jutting the head forward is preferred and a firm pillow under the knees can help support the hips, pelvis, and low back. For stomach sleeping, the pillow should be thin enough to not hold the head in awkward rotation for all the night.
Your mattress should also be supportive. Cushioning level is a personal preference, but you should make sure that your body is cradled in a comfortable and supportive position and that the mattress does not have deep indentations from long-term use, or that the mattress is not so hard that you wake up feeling like you slept on the floor.
I have more questions about sleep!
If you have any further questions, talk to your chiropractor at your next visit and see what they recommend for you and your body!