As a chiropractor, one of the questions that is always asked is what the best sleeping position, should I be sleeping on my back, side or stomach? Impaired sleep can aggravate health problems and interfere with the body’s natural ability to heal itself. Although there are many factors that facilitate restful sleep; room environment, mattress and pillow, body position is often overlooked and is a key contributor to a good night’s sleep. The unfortunate fact is that 80% of Americans will suffer from back issues at some point in their lives. Considering that we spend, on average, 1/3 of our lives in bed, it makes sense to ensure that we’re not sleeping in a way that contributes to our back problems.
First, if you’re a stomach sleeper, you need to do all you can to try and break the habit. Not only does this position put your low back in an awkward position of hyper-extension, but it also forces the neck into rotation throughout the night, which is extremely unhealthy for both regions of the spine. In addition, stomach sleeping can put pressure on internal organs and in order for you to breathe, you have to turn your neck to either side which puts pressure on your neck. So, if you are one that tends to gravitate towards sleeping on your stomach, try to sleep on your side. For stomach sleepers, try using a pillow against the chest region to recreate the compression you enjoy while sleeping on your stomach. For the side sleeping position, ideally we want to have a pillow between our knees. The width of this pillow to be approximately the width of a fist. This will serve to keep the pelvis in a neutral position, minimizing compression or twisting forces on the sacroiliac joints, which are a very common source of low back pain. The pillow under your head 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.
For the back sleeping position, ideally, we want to sleep with a pillow underneath our knees. The height of the pillow should be equivalent to about the width of two fists. By placing a pillow under one’s knees while back sleeping, the low back spinal joints are flexed just slightly, which prevents any jamming of these joints. Sleeping on the back evenly distributes weight and pressure on the spine, neck and joints. 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. Pillow choice and pillow position are both important. If you have questions be sure to ask Dr. Gina or Dr. Keeli about the water pillows they have in the office.
So, in short, back and side sleeping are best especially when the correct head pillow, mattress and knee pillow are utilized to promote a neutral and ultimately healthy spine. After doing some research, what has been discovered is most people shift between their sides and back throughout the night. Although through the REM stage of sleeping, we are effectively in a state of paralysis, meaning very little movement occurs. In the other stages of sleep, tossing and turning is common. Intuitively we know not to sit or stand for hours on end during the day because it is simply uncomfortable and causes pain throughout our entire back. It seems that we have the same cues that exist at night as well. When we lay in the side sleeping position, we often curl our legs up a bit which is more like a sitting position. However, when we shift to our backs, our lower back is now more in a standing position. Proper mattress and pillow support can facilitate a healthier sleep position and ultimately a more restful night’s sleep. 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 and it’s all about reducing pressure and preventing or eliminating pain and stiffness.
