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Taking a Position on Sleep


By Scott LaFee   |   August 28, 2019

​We all dream of a perfect night’s sleep. More than 50 million Americans reportedly suffer from more than 80 different sleep disorders, with another 20 to 30 million experiencing intermittent sleep problems each year, according to the American Sleep Apnea Association.

There are lots of remedies available for those seeking salubrious slumber. Some good; some ineffective; some you should avoid like a nightmare. They range from drugs to machines to lifestyle changes. Here, we’re taking a position on positions.

sleeping man

The general consensus among sleep experts is that lying on the back is usually best, at least in terms of a healthy back. The position evenly distributes weight along the entire length of the body, minimizes pressure points and helps ensure proper alignment of the head, neck and spine. Putting a small pillow under the knees can provide additional support and help maintain the natural curve of the spine. A pillow under the knees can also relieve knee pain.

(Note: Consensus doesn’t mean total agreement. Some doctors argue that sleeping on one’s back can impair breathing and reduce oxygen to the brain, even shorten one’s lifespan.)

Sleeping on one’s side is popular and for many quite comfortable, but it may pull the spine out of alignment and strain the back. Sleepers can remedy this by placing a firm pillow between the knees, which raises the upper leg, restoring natural alignment of the hips, pelvis and spine.

Sleeping on one’s stomach generally isn’t recommended. More on that below.

Here are eight more tips worth sleeping on.

  1. If you have back or neck pain, don’t sleep in the fetal position (on your side, knees scrunched up to chest, chin tucked down). It can strain the neck and head and compromise circulation and breathing.
  2. If you suffer from nighttime acid reflux or heartburn, sleep on your back with head elevated to ensure your stomach is below your esophagus. Or try sleeping on left side, which positions the esophagus in such a way that it’s harder for stomach acids to escape the stomach. Or you can elevate the head-end of your bed with blocks under those legs or a wedge under the mattress.
  3. Avoid sleeping on your stomach with head turned to one side. It can strain your neck, spine and lower back. If you like sleeping belly-down, consider using a thin pillow to minimize the angle of your neck and a pillow under your pelvis to keep your spine neutrally aligned.
  4. If you snore, try sleeping on your side. When you sleep on your back, your tongue can fall back in your mouth, obstructing the airway and increasing snoring. Sleeping on your side helps keep the airway open. Of course, snoring may be a sign of a more serious problem, such as sleep apnea. If you snore regularly, talk to your doctor.
  5. Sleeping on your back can help you avoid premature facial wrinkles because your face isn’t being compressed against a pillow night after night.
  6. Which side is best to sleep on? There are pros and cons. If you sleep on your left side all night, you can put strain on your liver and lungs; but if you sleep on your right side all night, it can exacerbate heartburn. Pregnant women are advised to sleep on their left side (rather than stomach or back) to take pressure off the uterus, stomach and breasts — and to optimize blood flow.
  7. Don’t sleep like a starfish (arms thrown above your head) if you wake up with shoulder pain. It may be due to excess pressure on the nerves in your shoulders.
  8. Sleeping on your side with knees slightly bent upward (but not full fetal position) can help minimize strain on back, neck and spine, but if you’re a woman, gravity may tug at your breasts, causing ligaments to stretch over time. To avoid that, sleep on your back or put a pillow under your breasts to support their weight.

There is, in fact, no single sleep position for all sleepers. The best choice is the choice that works best for each individual. If you currently wake up, refreshed and pain-free, then you really don’t need to think about the rest.

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