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#3 Sleep... What’s Your Position? Does it Matter?

Updated: Sep 2, 2021

Bits of healthful information to easily incorporate into your life...

Good health to you!

There are many opinions on the subject of the best sleep position. The information I share makes the most sense to me based on my experience as a massage therapist and the problems I’ve seen because of my client’s sleep positions.

Of course there are conditions in which a certain sleep position may be best for you. If you are pregnant, have acid reflux, sleep apnea, arthritis or some other condition, take your doctor’s recommendation regarding how to sleep.

It is difficult and not necessarily good, to stay in one position all night long, so it is ok to switch it up. In whatever positions you choose to sleep, it is important to keep proper alignment. Align your ears with your shoulders and your shoulders with your hips. When on your side, don’t always sleep on the same side.

Reading all of this, it may seem rather complicated, but it really isn’t. Once you find the position, it is comfortable, or it will become so if you give it time.

As for your head and neck, review pillow placement from my blog post

Of the many, many ways people sleep, we will look just at the four basic positions. Be sure to read the summary and suggestions at the end of this article.

Best: On your back (Supine)

Why? Your spine stays aligned in a neutral position and your weight is evenly distributed throughout your body. Your organs are not cramped, lungs and diaphragm move freely. You can avoid wrinkles because your face isn’t pushed into your pillow.

How? Lie flat with your face turned upward, chin pointing to your toes not to the ceiling. Add a pillow under your knees to relieve any pressure you may feel in your low back. To prevent potential shoulder pain, leave your upper arms in a position somewhat parallel to your torso. However, if you sleep with your hands clasped on your chest as in the picture, you may wake up with numb hands.

Good: On your side (Recumbent)

Why? Many people need an alternative to sleeping supine because of various medical issues. If you pay attention to how you position yourself, your spine will stay aligned.

How? Using bolsters can help you to stay aligned just as if you were lying on your back. Keep your body relatively straight with your knees one atop the other and a pillow between them. Be certain that your neck stays in line with your spine by not bending your head forward. To prevent potential shoulder pain, leave your upper arms in a position somewhat parallel to your torso. Hugging a pillow to your chest can keep your shoulder and chest from collapsing forward. Avoid bending your top knee letting it drop over onto the mattress (called the figure 4 position). This position contributes to sciatic pain and stresses your low back. If you must sleep in a figure 4, as in the picture below, prop your top knee on a pillow to keep your leg level with your hip. (For more information on preventing sciatic pain see my blog post Is Your Sciatic Nerve Acting Up? Try the Sciatic T).

Not so good: Curled up (Fetal position)

Why? There are a couple of good things that come from this position. It can help reduce snoring, and because your spine is stretched into a curve, a little bit of space is created between your vertebrae and this can relieve the pressure of back pain. There are problems also. An extreme curve can cause pain in your spine and neck. Being tightly curled will cramp your organs including your diaphragm, restricting your breathing. This position while sleeping will encourage your body to take on that same “C” shape when you are standing or sitting and encourages a forward head position. It will take more of a conscious effort to maintain good posture throughout the day.

How? Avoid curling up tight. Keep your legs straight enough to put a pillow between them. In order to combat the forward head position and neck pain, do not tuck your chin into your chest. Try clasping a pillow to your chest with the top tucked under your chin to help bolster your head and neck into alignment with your spine. See my blog

Bad: On your stomach (Prone)

Why? Sorry to all of you stomach sleepers. I could only find two benefits of sleeping this way and many reasons not to do it. The good is that it can reduce snoring and help people with apnea. The bad is that sleeping on your stomach puts a strain on your spine, hips, shoulders, neck and ankles. Because your spine is the superhighway for your nervous system, stressing it can cause pain to pop up anywhere in your body. Twisting your head to the side, besides the neck pain, can limit blood circulation and reduce the size of your airway. Keeping your arm turned in an upward position rotates your shoulder blade (scapula). There are 14 different muscles attached to each scapula so when you keep them rotated for an extended time you potentially make a lot of muscles unhappy. The prone position can even cause ankle pain and contribute to the pain of Achilles tendon (for more information on foot and leg pain, see my blog posts More About Your Feet… Practice your ABC’s!, Are You Strangling Your Feet?, Untuck Those Sheets! Be Kind to Your Feet!). And of course, if your face is smushed into your pillow, you press wrinkles into your face. Already have those sleep wrinkles? Look into taking my Zoom class Learn to Cup for Beautiful Skin. Find the information on the 'Take a Class' tab on my website.

How? If you just can’t sleep any other way, there are a couple of things you can do to help yourself. To decrease the angle of your head and neck, use a thin pillow or no pillow at all. To help take some of the pressure off your spine, put a pillow under your pelvis. A pillow under your lower legs relieves presser on your ankles. Avoid always having your face turned to the same side. Undulate when you get out of bed to lubricate all the joints that have been stressed through the night. See my blog post Undulate! A Perfect Way To Start Your Day

Here are a couple of helpful options for bolstering into a more neutral position:

As a summery remember:

  • Align your ears with your shoulders and your shoulders with your hips.

  • Always point your chin toward your toes not toward the ceiling.

  • Use pillows as bolsters to keep your body level and in place.

  • If you sleep on your side, don’t always sleep on the same side.

Good suggestions:

  • Be kind to your face, use a silk or satin pillowcase to lessen the friction of your skin against your pillow. Look into taking my Zoom class Learn to Cup for Beautiful Skin. Find the information on the Take a Class tab on my website.

  • If it's time to get a new mattress, I recommend you look into a Sleep Number Bed especially if you share your bed with someone else.

  • For pillow suggestions see my blog post Your Sleep Equipment

Now… go put the GOOD back in goodnight!

Good health to you!

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