by Carole Jackson, Bottom Line Health
So many people tell me that they canât get a good nightâs sleep! Even when they try all the well-known tricks — such as darkening the room, relaxing before bed and drinking warm milk — a restful nightâs sleep still eludes them. But what few people seem to consider is the position they sleep in and how that impacts the quality of their sleep. In fact, the position you choose can contribute to a whole range of sleep-interfering problems including neck, shoulder and back pain. If you sleep in a position that makes your body hurt or feel stiff, you may be forced to try positions that leave you in even more pain. On top of it all, your sleep position can contribute to acid reflux (more on that below).
To explore which sleep positions are the worst and which are the best, I called Christopher Rose, MD, medical director of the sleep center at the Covenant Medical Center in Lubbock, Texas. He gave me the pros and cons of sleeping on your side, back and stomach and suggested ways to modify each position to better assure a restful sleep.
Sleeping on Your Back
This is the ideal position for the vast majority of people.
- Advantages: Itâs most likely to keep the head, neck and spine in a healthy, neutral position… it helps prevent or lessen acid reflux… and as a bonus, it is the only position that does not contribute to facial wrinkling.
- Disadvantages: Back sleeping is not good for those with sleep apnea, people who snore or pregnant women after their fourth month. Dr. Rose explained that when people with breathing issues lie on their backs, pressure on the airway in the back of the throat increases, triggering improper breathing. And pregnant women should avoid back sleeping in the later months to keep the weight of the growing fetus off the intestines and major blood vessels (the aorta and vena cava), so that blood flows more freely to the fetus.
Back-sleeping tips: Your pillow should be 100% comfortable for you — for most people, this means soft and not very thick. Position it so that it doesnât force your chin toward your chest, an unnatural position that can create neck pain, said Dr. Rose. If you already have neck pain, consider a cervical pillow — a pillow with thick padding in a horseshoe-shape around the outer edges and less padding in the center and along the bottom edge. Adjust it so that your head fits comfortably in the middle and your neck is supported by the padding along the lower edge. It will align the cervical spine and support your head, preventing cervical strain. If you have pain in your lower back, place a pillow under your knees to prevent back strain.
Sleeping on Your Side
This position is second best for most of us — and the best for snorers and those with back pain.
- Advantages: Because it elongates the spine (on your back, the vertebrae stack naturally together… on your side, they are pulled apart a bit), side-sleeping can help ease back pain. It may also prevent snoring just by the positioning of the tongue, uvula and epiglottis, and it reduces risk for acid reflux since your stomach can flop down to the side and “kink” the gastroesophageal junction a bit to slow down reflux.
- Disadvantages: Side-sleeping puts uneven weight on the neck and shoulder — the downside shoulder bears more weight than if you distribute your weight more evenly across both shoulders on your back — so it can exacerbate problems you might have in those areas. Side-sleeping causes wrinkling on the side of the face you sleep on and, because it leaves the breasts hanging, over time it encourages them to sag.
Side-sleeping tips: Pregnant women and people with acid reflux might find it better to sleep on the left side only, said Dr. Rose. For a pregnant woman, sleeping on the left side keeps the fetus off the motherâs vena cava, assuring a healthier blood flow to her heart and to the fetus. And because the stomach is on the left side of the body and the esophagus is to its right, left-side sleeping positions your stomach below your esophagus, helping to prevent stomach acid from creeping into the esophagus. If side-sleeping makes your shoulders sore, Dr. Rose suggested that you stretch them during the day by rolling them forward and then backward, 10 times per side. Side-sleepers with hip problems should place a pillow between the knees, which keeps hips in better alignment and reduces pain.
Sleeping on Your Stomach
Without question, this position is the worst for most people.
- Advantages: None, other than for snoring and apnea, but both these conditions are better addressed with side-sleeping, said Dr. Rose.
- Disadvantages: Sleeping on your stomach forces the spine out of its natural S-curve alignment, potentially causing pains, numbness and tingling. It forces the head to one side or the other, further distorting the alignment of the neck and spine. More bad news: This position worsens gastric reflux.
Pillow Talk
You may have been sleeping in the same position for decades — maybe for your whole life. But that doesnât mean that itâs the best position for your sleep or your health. To train yourself into adopting a sleep position that will better serve you, pillows are the way to go. To encourage side-sleeping, lie down as comfortably as possible in the side position and then grab two cylindrical or rectangular pillows that are about body length. Put one right behind you and one right in front of you. To convert to sleeping on your back, get two small pillows. Prop one on each side of your head on top of your main pillow.
When choosing a pillow, Dr. Rose said, just go with personal preference. There is no scientific evidence to prove that a soft pillow has advantages over a firm one or vice versa. This is also true for mattresses — despite advertisements to the contrary, there is no research proving that a soft, medium or firm mattress is best for sleep for most people. Itâs highly individual.
Finally, if you are one of those rare folks who sleeps soundly and has never had a complaint about the quality of your sleep, Dr. Rose said, the best position for you is clearly the one you have — whatever that might be.
Source(s):
Christopher Rose, MD, medical director of the sleep center at Covenant Medical Center in Lubbock, Texas.