The importance of getting a good night’s sleep has been supported by countless studies. However, according to the National Sleep Foundation’s inaugural Sleep Health Index, 45 percent of Americans suffer from a lack of sleep. (1)
Impaired sleep can aggravate medical problems and interfere with the body’s natural ability to heal itself. Although there are many factors that facilitate restful sleep, including room environment, mattress and pillow, body position is often overlooked and is a key contributor to a good night’s sleep.
Sleep Positions Matter — Are You a Back, Side or Stomach Sleeper?
There are three main sleep positions: back, side, and stomach. Although back and side sleeping positions are recommended by most sleep experts, doctors also stress that sleep position should be an individual decision based on each person’s specific needs and comfort preferences.
Here are the benefits and potential issues associated with each sleep position:
Sleeping on the back evenly distributes weight and pressure on the spine, neck and joints. Back sleeping is thus a very comfortable position for many people and may allow for better circulation and optimal rest. According to Dr. Sol Cogan, the chiropractor for the Detroit Lions from 2002 to 2015, “Sleeping on your back reduces pressure on the discs so it’s better for the back and neck.”
Still, back sleeping, like all sleep positions, can have potential pitfalls. Dr. Jason Levy, chiropractor to the New York Jets points out, “If you are a back sleeper, you want to make sure your neck is supported nicely and your head does not get pressed up too high or fall back too low.” The ultimate goal is for the neck to be in alignment with the spine, which can be achieved through proper pillow support or mattress position if you have an adjustable bed frame. The right mattress makes a difference.”
Back sleeping has also been correlated with higher rates of snoring, which can keep your partner awake, and sleep apnea. A study conducted by the National Institute of Health found that the incidence of sleep apnea was twice as high during the time patients slept on their back versus their sides. (2) If you suffer from either of these, including finding out how to stop snoring, you may want to discuss sleep position with your doctor.
According to the Better Sleep Council, 69 percent of people sleep on their sides. (3) Dr. Lou Bisogni, a leading New York chiropractor, notes that for most people, “The best sleep position is a side posture fetal pose, with legs curled and pillow between your knees, which keeps the pelvis level and reduces the chances of lower back irritation, stiffness or pain.”
Side sleepers are less prone to snoring but are more likely to experience nerve compression that can cause neck and back pain, even sciatic nerve pain. Therefore, pillow choice and pillow position are both important. According to Dr. Cogan,
For the side sleeper, the pillow should be firm enough to support the head and high enough so that the head is in a neutral or even position. This reduces stress and pressure placed on the neck, which will cut down on neck pain, muscle aches and stiffness. The proper pillow supports the head and neck and never the shoulders.
Of course, there are two sides to the body and research shows there are different advantages and disadvantages depending on the side you sleep on. For example, sleeping on your left side can help reduce acid reflux. Dr. Bisogni notes this is because left side sleeping keeps the stomach below the esophagus and gravity helps keep the reflux at bay.
Sleeping primarily on the left side is not without its limitations. It can put a strain on internal organs like the liver, lungs and stomach. Perhaps because of this, The Cleveland Clinic recommends that side sleepers alternate sides during the night. (3)
Experts agree that the sleep position associated with the most potential disadvantages is resting on the stomach. Sleeping on the stomach can have negative impacts on digestion and circulation and can create pressure on the back and neck. In order to breathe, stomach sleeping requires the neck to be bent in one direction or the other. This twisting of the neck causes strain and pressure. Even if an individual gets a restful sleep on the stomach, they may feel sore, develop a stiff neck or have neck pain during waking hours due to the craning of the neck that stomach sleeping requires.
As Dr. Cogan notes, “For most people, the worst way to sleep is flat on your stomach because it increases the amount of pressure on the lumbar spine (lower back) and, in order to breathe, you have to turn your head one way or another, which puts pressure on the neck.”
In addition, stomach sleeping can put pressure on internal organs. According to Dr. Bisogni,
It causes more pressure to be put on your heart and lungs, and it takes 25 percent more energy to sleep that way. For those who are obese with big bellies, it can put even greater pressure on the lungs. Also, stomach sleeping may add to the complication of snoring and sleep apnea.
No sleep position is without benefits, however. Dr. Bisogni notes that some research suggests that people sleeping on the stomach are more restricted in their movements, which may result in a deeper sleep.
If you are a stomach sleeper and want to try to change positions, Dr. Levy suggests you may ease the transition to a side sleeping position by wedging a pillow between your stomach and the mattress. This may feel more comfortable than side sleeping alone and may prevent people used to stomach sleeping from rolling onto their bellies while asleep.
Other Factors that Affect Sleep?
Upper Body Elevation
Sleeping with the upper body in an inclined position can reduce acid reflux and in some cases help mitigate snoring. According to the National Institute of Diabetes and Digestive and Kidney Diseases, approximately 20 percent of the population has GERD (gastroesophageal reflux disease). (4) It occurs across every age group and ethnicity and most Americans suffer from some type of reflux or occasional heartburn at some point in their lives.
Dr. Michael Schmidt, a leading northern New Jersey gastroenterologist, recommends that patients sleep with their head in an elevated position to combat reflux: “Gravity prevents acid and other corrosive elements from refluxing into the esophagus.” Dr. Schmidt often suggests purchasing over the counter aids designed to elevate the head or using an adjustable power foundation to elevate the “pillow end” of the bed.
The Right Mattress and Pillow
Experts, especially leading chiropractors, agree that proper mattress and pillow support can facilitate a healthier sleep position and ultimately a more restful night’s sleep. According to Dr. Bisogni, mattresses should have some contours that support the three natural curves we are born with: the cervical lordosis, the thoracic kyphosis and the lumbar lordosis. “Memory foam mattresses contour to the body, reduce pressure points, and support these three natural curves most effectively,” he says. Memory foam forms to the body in response to heat and pressure, evenly distributing body weight.
Dr. Cogan agrees that a memory foam mattress that conforms to the body is healthy: “It keeps the spine in the right alignment and because of the technology they use and the memory foam, it gives you support where support is needed.”
Dr. Levy notes the proper mattress is especially important for someone who is overweight. This is because a mattress that is too soft is going to have a significant “hammock” effect (dipping in the middle) as weight placed on it increases. By contrast, if the mattress is too firm, it can create significant pressure and be very uncomfortable.
In terms of pillow support, Dr. Cogan notes, “The pillow, no matter what the sleeping position, should cushion and support the head. The pillow should also conform to the shape of the neck as well.”
In the end, we all have to find the sleep position that is most comfortable and healthiest for us given our specific physical concerns. Sleep is the body’s natural recovery and healing process from the stressors it’s subjected to during the day.
We can protect our health by making sure that we are fully rested so that our immune system has the resources it needs to work well. “It really comes down to finding a comfortable way to sleep,” says Dr. Cogan,” and it’s all about reducing pressure and preventing or eliminating pain and stiffness.”
This article was written by a Dr. Axe affiliate, Bioposture, which provides memory foam mattresses and pillows, both of which Dr. Axe uses. Dr. Axe customers will receive a 10 percent discount for a select time.