Whether you’re a stomach, back, or side sleeper, there are steps you can take for better rest (and fewer back or neck aches).

By Nicole Clancy
September 30, 2019
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If you’re tossing and turning all night or suffering from sleep problems, your sleeping position may be to blame (at least in part). When your body is in a bad sleeping position, your brain sounds an alarm to wake up, leading to a disrupted sleep pattern that can repeat all night long. Instead of waking up refreshed, you have achy muscles and sore joints—and not just because you may have fallen asleep with your neck at a strange angle.

Your brain sounds an alarm—leading to poorer quality sleep—when you’re in a less-than-great sleeping position for an important reason. Your whole body—organs, muscles, all of it—relies on sufficient blood flow to function. Sleeping or awake, this blood flow is critical for your survival. If you’re sleeping in a bent, twisted, or torqued position that is limiting or compromising blood flow, your brain, as a protective function, will signal your body to move, and when you move, you wake up. The result can be minimal restorative sleep and body aches and pains night after night, even if you’re stretching before bed. Luckily, this pattern can be broken by repositioning your body.

The power and importance of sleep for total health simply cannot be underestimated. Rajwinder Deu, MD, Assistant Professor in the Department of Orthopaedics at Johns Hopkins University, says, “Sleep is an essential body function. A number of studies have shown negative effects on both physical and cognitive performance with poor sleep. Specifically, studies have shown that it can inhibit endurance performance, accuracy, reaction time, and learning. In addition, studies have shown increased risk of injury likely due to fatigue.” With that in mind, it’s worth the time and effort to find out how your body and brain sleep best. (There’s a reason people obsess over pink noise or Brown noise and other sleep aids.)

“Pillow up to arrange your body in proper alignment for sleep,” says Colleen Louw, PT. She defines proper alignment (or neutral spine) as your head, neck, and spine all resting in one line. Since you’re not aware of your position when you’re sleeping, the easiest way to keep your body in the proper sleeping position is to use pillows to pad, prop, and act as bumpers.

Using pillows or wedges of varying sizes and thickness is the best way to start. The so-called best sleeping position really is different for every body, so paying attention to how you feel when going to bed is your best feedback. “When you feel nothing physically when going to sleep, then you’ll know you’re in the right position,” Louw says. Here are easy ways to make three popular sleeping positions better for your body, and thus better for your sleep.

Stomach sleeping

Louw says to avoid tummy sleeping because this position places your neck and back into extension (an arched back position), which means there’s restricted blood flow, which can upset your nerves. “Your brain is reacting to your neck and back being in a bad position,” Louw says. You could place a pillow under your belly button or pelvis to help your lower back, but your neck is still stuck in a compromised position. Your head will be turned to the left or right, and holding this stationary position will stress your neck. This combination makes stomach sleeping less than ideal for your spine.

Back sleeping

Sleeping on your back is also not great, especially if your knees are out straight. A straight-legged position puts your lower back into extension, much like stomach sleeping does. Louw says the best way to improve this sleeping position is to put two pillows under your knees to keep blood flowing. Modifying your lower back position is key, as is avoiding a big pillow under your head. A large, over-stuffed pillow can place pressure on the spinal discs in your neck, Louw says.

Side sleeping

While side sleeping seems to be the least consequential for spinal health (making it the best sleeping position for most people), it does take some getting used to, if arranged properly. “I encourage side sleeping,” Louw says. “You should have your shoulder on a flat pillow to prevent your upper body from rotating forward or backward.” Placing your head on a regular pillow is sufficient. She also recommends a pillow between your knees, and a pillow between your ankles. Adding pillows to your knees and ankles prevents rolling forward or backward, which twists your hips and shoulders. If your ears, shoulders, hips and ankles are all in a line, you’re good to go.

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