Research & Publications

Are You Sleeping in the Wrong Position?

Date Posted: Tuesday, September 2nd, 2014 by Alan Berger

Our sleeping position is mainly a matter of comfort but may be dictated by some health issues.  No matter what position you choose to sleep in, it must be comfortable so that you can get that 8 hours of recommended rest each night.  All sleeping positions have positive and negative points but some are better for particular issues than others.

Side sleepers

Sleeping on one side or the other is the most common sleep position.  Most people have a particular preference and you can actually tell which side they sleep on over time because the ear on that side will be closer to the skull.  Whether in the fetal position or stretched out, the benefits of side sleeping are:

• Prevention of snoring – most snoring is produced when sleeping on one’s back.  Switching to a side position may help open the airway and avoid obstruction from throat and neck tissue.
• Improved circulation – side sleeping on the left side particularly helps the heart pump more efficiently and may provide benefit to those with circulatory problems.
• Comfort during pregnancy – as a woman nears childbirth, side sleeping is often the only comfortable position. Back sleeping causes the baby to press on abdominal organs. Stomach sleeping is close to impossible.
• Relief from restless leg syndrome and leg cramps – sleeping on the side with the legs drawn up in a near fetal position may provide some relief from restless leg syndrome (RLS) or nighttime leg cramping.

Side sleepers need to avoid spinal curvature and may need abdominal or side support.  For some, a body pillow may help while others prefer to roll further over.  Some side sleepers also experience pain from the knees resting against each other or in the lower back. The Mayo Clinic recommends sleeping with a pillow between the knees to alleviate back strain.

In addition, you need to make sure that your head is in alignment with your shoulders so a good supportive pillow is essential.  If you are concerned about facial wrinkles, a silk pillow case may be less drying and won’t pull the skin as much but many people find them “slippery”.

Back sleepers

Sleeping on your back is actually not that common but is often the position people try to start out in when going to sleep.  It minimizes face and neck wrinkles as your face is not pressed against the bed surface. Back sleeping may also be beneficial to those with:

• Spine problems - back sleeping can be the best for spine alignment but it is important to use the right kind of pillow with neck support so that the neck and head are kept in line with the spine.  A “neck pillow” may provide some support to your cervical area and help you avoid strain. 
• Acid reflux – back sleeping can minimize acid reflux but the head must be slightly higher than the stomach.  If acid reflux is a problem, a wedge shaped pillow may allow you to elevate your head and remain comfortable.
• Allergies – if nasal drainage is a problem, back sleeping may provide benefit, but again the head should be slightly above the rest of your body.  Try the wedge pillow for some drainage relief, but if allergies or other conditions are contributing to sleep apnea, back sleeping is not for you and most people with allergies should avoid feather or down pillows.

Back sleeping may produce lower back pain which can sometimes be alleviated with a pillow placed under the knees.  There are pillows that are commercially available for this purpose but you can just as easily use one of your own. 

Those who are bedridden should seek medical advice before using a knee pillow as it can increase the risk of blood clot formation in the legs if used for long periods of time without exercise.

Stomach sleeping

Stomach sleepers are fairly rare but may be good bed partners. Stomach sleepers are less likely to snore because their airways are opened; however, this position can put stress on the lower back and should probably be avoided by those with back problems.  Children are more prone to stomach sleeping than adults, though the American Pediatric Association no longer recommends putting infants on their stomachs due to the increased risk of suffocation.

People who like stomach sleeping may be concerned about wrinkles as the face is pressed into the bed or pillow.  Those that don’t like stomach sleeping may feel claustrophobic or suffocated. It may also cause back pain.  Using a thinner pillow for the head and placing a thin pillow under the hips or forgoing the pillow altogether may help. 

Whichever sleeping position you prefer, getting comfortable with a good night’s sleep is essential.  Lack of sleep doesn’t just cause fatigue or grouchiness, it causes real health problems.  Don’t be afraid to invest in a quality pillow – or more than one if you need it.  You may have to try out a few but with all of the options available, each designed for a different purpose, the right one is out there.

Referenced Material

1. The Huffington Post: Your Guide to the Best (And Worst) Sleep Positions http://www.huffingtonpost.com/2014/06/20/sleep-position-health_n_5500859.html  (6/20/2014)
2. The Mayo Clinic: Diseases and Conditions, Sleeping Positions http://www.mayoclinic.org/diseases-conditions/back-pain/multimedia/sleeping-positions/sls-20076452 (2014)
3. The Better Sleep Council: Sleep Positions http://bettersleep.org/better-sleep/sleep-positions (2014)