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Which Sleep Position is Best for You?

Dr. Lisa Goodman, DC

We spend about ⅓ of our life sleeping, which equates to almost 230,000 hours. That’s a lot of time, so it’s important to think about how your body can be affected. The position that you sleep in can be a factor in why you wake up with neck or back pain and why it is not getting better. There are 3 main positions we sleep in: on our back, side or stomach. Here is our advice on the best ways to enhance your preferred sleeping position:

Back: Sleeping on our back, face up, is considered to be the most optimal sleeping position due to equal distribution of weight along the spine. We suggest adding a pillow under your knees in order to keep the spine in the most neutral position. Your head should be placed in the middle of the pillow to support the neck and limit muscular strain. When choosing a pillow, look for a thinner one that is going to keep the head in a neutral position. You don’t want your head to be flexed too far forward to extended back because this will create straining of the muscles that support the head. Using an ergonomic pillow with a crater in the center, such as the TriCore Pillow, for the head can help keep it in the neutral position. When choosing a mattress, it is best to have a medium firmness mattress if you sleep on your back because it helps support your spine while keeping it in a neutral position. Back sleeping will reduce waking up with lower back and neck soreness. PRO TIP: If your hands fall asleep or tingle when you sleep on your back, you may be bending them too severely at the elbows. Try to keep your arms straight or bend only about 60 degrees when sleeping.

Side: If you are a side sleeper, one thing to keep in mind is to make sure you consistently switch sides. If you only sleep on one side, that side is going to have increased stress on it and will ultimately lead to problems down the road. We suggest that a pillow be placed in between the knees and ankles in order to help maintain proper spinal alignment. When choosing a pillow, look for a thicker one that is going to help support your head while also keeping it in a neutral position. We love the customizable Coop Pillow. If it’s too thick, it will create too much side bend in the neck, causing strain on the neck muscles and even shoulders. It is best to have a soft-medium firmness for a mattress for this sleeping position to help support both your head and low back. PRO TIP: If your shoulders or arms are hurting or tingling while sleeping on your side, try to make sure they are wrapped around a medium to large pillow when you sleep. Try to avoid placing arms overhead when you sleep on your side.

Stomach: Sleeping face down on the belly is the least recommended sleeping position, because it causes stress on both the neck and low back. Sleeping on your belly puts the spine in an unnatural position, causing muscles of the neck to turn on and support the head when they should be relaxed. The neck sustains maximum strain because the head needs to be turned 90 degrees to one side or the other. This position also flattens the natural curve of the spine, actually creating too much extension (pelvic tilt) in the lower back. If you do sleep on your belly, it is recommended that no pillow or a very thin pillow be used. We generally do not recommend belly sleeping as it can lead to long term neck and back pain even in the best circumstances. Please consult with your chiropractor on the best position for you. Sleep tight!

Sleep during pregnancy: During pregnancy it is not recommended to sleep on your stomach or back. Sleeping on your back compresses your inferior vena cava, the vein carrying blood from the lower part of your body back to your heart. Most of the time, if you are on your back for tool long your body will wake you up! If you do sleep on your back, try adding a wedge under your left side to reduce some of the pressure. So that leaves sleeping on your side, specifically your left side. While sleeping on your right side is fine, sleeping on your left side provides more blood flow to your baby and improves kidney function. PRO TIP: If you are having discomfort while sleeping during pregnancy, a prenatal chiropractor can help! They can also help with pesky hand tingling and numbness as many times this is resulting from fluid retention in muscles around the neck.

Good sleep is the name of the game

While sleeping on your back or side are optimal for most people, there is no one perfect sleeping position. Just like there is no perfect ergonomic working position. Having the ability to sleep in three positions throughout the night is key! Therefore, if you can set yourself up for a good night's sleep with a variety of sleep accessories and a soothing environment you will be in good shape. I recommend:

  • Lots of pillows

  • A supportive mattress - not to firm, not too soft

  • A cozy and supportive pillow for your head

  • Cozy pillows for your legs and arms

  • White noise or a fan

  • A dark room

  • Loose bedding - PRO TIP: tucking in bed sheets can lead to heel pain, achilles pain and plantar fasciitis so let the feet have plenty of room to move!

Give yourself permission to be an imperfect sleeper! It is ok to roll over, lay on your back or other side during the night.

Lisa Goodman, DC, CCSP, CACCP founded Washington Park Chiropractic in 2006 in Denver, Colorado. Dr. Goodman is a Certified Chiropractic Sports Physician (CCSP) and Certified Prenatal and Pediatric Chiropractor (CACCP). She is TPI-L1 certified through the Titleist Performance Institute. She is also a CrossFit Level 1 and CrossFit Kids Certified Trainer. Dr. Goodman incorporates sports chiropractic techniques with prenatal and pediatric patients. She is a regular speaker at national events including Parker Seminars. She is part of the USGA Performance and Recovery Team. She is a member of the ACA Pediatrics Council and the ACA Sports Council. Areas of special interest include golf biomechanics, youth athletes, ankle and wrist injuries, instrument assisted soft tissue techniques. Stay connected with Dr. Goodman on Instagram @washparkchiro or @drlisagoodman


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