My guess is that you haven’t given much thought to sleeping positions. That could be a big mistake. Most people sleep in whatever position feels most comfortable for them in the moment. If you’re like me, you probably have a couple favorite positions, “go-to” positions that you rely on to get to sleep quickly. I have used a cycle for many years that moves me counter clock-wise until I fall asleep. The problem is that the position I most frequently end up using is not very healthy.
You may be surprised to learn that sleep position matters at all. I mean, what difference could it possibly make what position my body lies in while it’s asleep, as long as I’m asleep, right? Wrong.
Given that we spend about 1/3 of our lives asleep, it makes sense that body position is very important. Most of us are aware that if we make certain repetitive motions over and over we may become injured, not because of the difficulty of the movement, but because of the constant gradual wearing down of muscles, tendons and tissues through repetitive motion. Carpal Tunnel Syndrome is the most famous example of a soft-tissue repetitive stress injury.
In a similar way, being in one position for long periods of time can be harmful if the position is contrary to the way our bodies were designed to be. Sleeping in an improper position can inflict harm to the body in a single night. Ever wake up with a stiff neck or back? Extend that out to days and weeks of poor sleeping habits and you could develop chronic neck and back injuries. Tens of millions of people visit chiropractors every year for chronic back and neck pain and one of the most common causes of such pain is essentially repetitive stress due to poor sleep habits.
Sleep can cause back and neck pain for three main reasons:
- Sleep quality
- Sleep Equipment, such as mattresses and pillows
- Sleep position
Although there are variations on these, there are essentially three main positions of sleep. Any sleep position should be evaluated according to the support and correct alignment of the neck, lower back and hips. The quality of sleep matters the most, with a silk pillowcase you can sleep comfortably and feel luxurious.
Description – The person lies on their back, head on the pillow and facing straight up towards the ceiling.
Evaluation – The back position is an ideal sleep position. It is easy to keep the spine and head aligned properly. The only issue is what to do with the feet. If there is room under the covers the toes should point up to the ceiling, but often the feet have to angle outwards somewhat. As long as this is kept to a minimum there shouldn’t be a problem.
Enhancements – A simple way to improve this position is to place a second pillow underneath the knees. This gives additional support for the hips and also makes it easier to keep the toes pointed upwards. Another great way to improve this position is to get a cervical neck support pillow. Such pillows are designed to provide additional support for the cervical spine (neck) while cradling the head for excellent comfort. One popular brand of pillow is the Tri-Core Pillow, which is available at Amazon.com. I just noticed that it is on a huge discount right now, marked down from $65 to only $26.34 for a 59% savings!
Description – Lying on your side with legs relatively straight, head on its side resting on a pillow, arms in front of the body.
Evaluation – The side position is another ideal position for sleep. Once again, the spine and head are kept in alignment easily. The legs can be bent slightly at the knees and hips. However, do not bend so far as to go into a fetal position where the back becomes somewhat arched. This puts too much strain on the back and neck. The tricky part of this position is what to do with the arms and shoulders. Having a pillow of appropriate thickness can help with this. I usually keep my arms folded in front of me, or curled up under the front of the pillow.
Enhancements – Place a second pillow between your knees, which keeps the knees in better alignment. Also, make sure you have good enough support from your head pillow. Too thin and flimsy and your head will bend down awkwardly. Too high of a pillow and your head will be forced to bend upwards. The cervical pillow mentioned above does provided a correct height and firmness for side sleeping as well as back sleeping.
Description – the person lies on their stomach, or most of their stomach, with the head turned to either side to lay on the pillow. Arms can be down at the sides or up around the pillow.
Evaluation – This is one of the most popular positions for its comfort. However, it is a terrible position for the lower back, and especially the neck. In order to be able to breath the head has to be turned sideways 90 degrees from front which puts a lot of strain on the cervical spine. It also may put additional stress on the abdominal muscles.
Enhancements – Avoid this position. I admit that this position is one of my favorites, and it is probably one of the main reasons why I suffer a lot of stiff necks. I am going to make it a goal this year to kick the front sleeping position habit!
Changing your Sleeping Position
If you are already a back or slide sleeper, congratulations! You may want to consider employing some or all of the recommended enhancements to get even more from your sleep’s restorative powers.
If you are a front-sleeper like me, join me in kicking the habit. Remember that, although another position may feel uncomfortable at first, it usually only takes a few days to get used to it. However, the benefits of switching to a healthier sleep position can pay off in big ways for the rest of your life!
You may need to introduce a new position gradually. Follow these steps to learn to sleep in a new position:
- Begin by following good pre-sleep practices, so when the light turns out you are drowsy and ready to fall asleep quickly. This can enable you to fall asleep in any position in just a few seconds.
- Then, start out on your back or side, whichever is more comfortable. If you become uncomfortable and have to change positions, try switching to the other good position (back to side, or side to back)
- If you find that you are not able to get comfortable you may eventually choose to turn back to the front position until you fall asleep. At least you have spent a little time in some good positions, and over time these will become more comfortable to you. Each night, try to extend the amount of time spent on your side and back before switching to the front.
- However, another option, instead of reverting back to the front position, is to sit up, turn on the light and spend some more time reading until you get sleepy again. Then go back to the side and back positions. Repeat this process until you finally achieve sleep. Over a few days of doing this your body will learn to become relaxed and comfortable with the back and side positions and sleep will become much easier.
If you are considering trying a cervical neck pillow, keep a few points in mind.
First, it is hard to overestimate the value of taking care of our necks and backs. Even if you don’t currently suffer from any such pain you may wish to try out a cervical neck pillow. I plan on taking advantage of the huge discount on the Tri-Core pillow at Amazon before the price goes up.
Second, adjusting to a new pillow, especially an ergonomic pillow like a cervical neck pillow, make take a few days. These pillows will put your head and neck in different positions than what you are used to. It is possible that you will experience some stiffness and soreness the first few days of use, as if you have had a neck workout. That is completely natural. You may want to introduce the pillow slowly, using it only for a few hours the first few days and building up to a full night of usage.
Thirdly, because an adjustment is required for new pillows, I do not recommend you try to adjust to a new pillow at the same time you are adjusting to a new sleep position. It would be better to train yourself to sleep in the right position first, and consider changing to an ergonomic pillow later.
If you are a front sleeper who is kicking the habit this year share your experience in the comments!