We spend about one-third of our lives sleeping—or at least trying to: getting our rooms to the perfect temperature and lighting, nestling under just the right amount of covers, arranging our limbs into the best sleeping position. And yet sleeping—one thing that should be so easy—is a struggle for many.
Of course, sleep is complicated. Sleep quality is a major health issue for Americans. According to 2014 numbers from the Centers for Disease Control and Prevention, 35.2 percent of adults get less than seven hours of sleep per night.
If that sounds like you and you’re looking to make a change, take note: Your bedtime and your sleeping position aren’t the only factors that determine the quality of your sleep. According to the Division of Sleep Medicine at Harvard Medical School, improving your sleep hygiene—the habits that affect your sleep—can make a substantial difference. If you’re on prescription medication, living la vida loca, feeling especially stressed out at work, or are indulging in a few too many coffees a day (especially close to bedtime), look at tweaking those parts of your life where you can.
But if you’ve already zenned out around matters both professional and personal, you eat the healthiest foods at the healthiest of times, and your bedroom is perfectly designed for a peaceful slumber—and you still can’t sleep, it might be time to look at how you’re sleeping. Specifically, you need to figure out the best sleeping positions for you because the way you sleep impacts how good that sleep is—and your overall health.
“The biggest purpose for sleep is to help us recover from the activities of the day physically, mentally, and emotionally,” says Scott Bautch, chiropractor and president of the American Chiropractic Association’s Council on Occupational Health. “The physical part is that if I sleep in a good posture, meaning neutral, my spine is resting, and everything is in the right position…I’m trying to help the body recover by trying to be as neutral as possible, so those ligaments and muscles get a chance to recover from the activities of the day.”
A poor sleeping position can contribute to all sorts of conditions, from insomnia to back pain. But you can make a few minor changes to the way you lay to figure out the best sleeping position. Don’t be surprised if you see—and feel—major results.
Best Sleeping Positions: The Basics
Sleep specialists typically break down positions into three categories: side, back, and stomach. Within those three categories, there are plenty of variations. For instance, sleeping in the fetal position will actually affect you differently than sleeping with your back straight in what some refer to as the log position.
Sleep specialists typically make a simple recommendation: Do what makes you comfortable. If you’re having issues falling asleep or staying asleep, however, the best sleeping position for you likely involves sleeping on your side.
That’s especially true if you have trouble breathing in other sleep postures. Harvard’s Division of Sleep Medicine also suggests that side sleeping is the best sleeping position for you if you struggle with troubled breathing at night as it may reduce the risk of obstructive sleep apnea (OSA), an extreme and potentially dangerous type of snoring. The school notes that weight loss and continuous positive airway pressure (CPAP) therapy are more effective methods of ensuring long-term healthy sleeping, but if you only experience breathing issues while sleeping on your back, you might consider being comfortably situated on your side as your new best sleeping position.
Best Sleeping Positions for Insomnia
Around 10 percent of American adults suffer from daytime impairment resulting from insomnia and around 30 percent of American adults deal with regular sleep disruption. It’s clear that sleep is a problem in America, and it seems to be getting worse: According to reporting from The New Yorker, insomnia diagnoses rose from fewer than one million to more than five million between 1993 and 2006. It’s a big deal, considering that sleep deprivation can seriously affect health.
To treat insomnia, you have to identify the cause of the condition. That’s not always easy, though, since everything from diet to television-watching habits can affect how you sleep (or don’t). One factor that researchers generally agree upon is that finding the best sleeping position for you can affect whether or not you’re getting healthy sleep.
Issues like back pain and indigestion can also contribute to insomnia, and if you’re constantly tossing and turning to try to get more comfortable, that won’t help you solve any of those issues. That’s why identifying any other physical issues—and attempting to remedy those through sleeping positions and other measures—is key.
Best Sleeping Positions for Back Pain
Back pain is incredibly prevalent. In 2012, the American Physical Therapy Association reported that nearly two-thirds of Americans experience low back pain. Put another (equally painful) way, on any given night, some 31 million people will suffer from low back pain in the States alone.
Even worse, low back pain and poor sleep work together to make sufferers miserable: One study from The Clinical Journal of Pain found that a bad night’s sleep indeed led to a day of increased back pain. Here’s the kicker: A day of worse pain was also associated with a bad night’s sleep! It’s easy to fall into a downward spiral of pain and fatigue.
Finding the best sleeping position for back pain that works for you could be a game changer. Here’s what medical science says about finding the best sleeping positions for back pain:
Supine Sleeping (or Log Position)
The best sleeping positions for back pain involve keeping your posture neutral, meaning that the body doesn’t bend or twist out of line. Bautch explains, “If you’re standing up and your ears are over your shoulders, and your shoulders are over your hips, and your hips are over your knees, there’s a neutral posture from front to back and left to right. So we want to reproduce that [in sleep].”
Whatever you do, don’t sleep on your stomach, researchers say. The key to finding a healthy sleeping position that eases pain in your back is to keep the spinal column aligned according to its natural shape, which requires support. Sleeping on your stomach doesn’t offer much support for the spine and may even push it into an unnatural curve.
Sleeping face-down can lead to other health problems as well, Bautch warns. “That’s by far the worst,” he says, referring to stomach-sleeping. “People that sleep on their stomachs have more hand and arm problems than any other population…And because we’re not going to breathe into our pillows, we twist our neck all night long. Often we bring our knee and arm up. We’ll put our hand underneath our head, and that continued irritation, we don’t recover from. As life goes on, we start to have more numbness symptoms in our neck and arm.”
Your spine is a long cord of vertebrae, the smaller interlocking bones. Between each vertebra, there’s a squishy intervertebral disk—the skeleton’s shock absorbers. These disks are mostly made of water. Why is this important? When you’re upright, you put pressure on your intervertebral disks, slowly squeezing out some of the fluid. Sleep is when your disks rehydrate. Therefore, the best sleeping position for back pain is one that evenly distributes your body weight to keep pressure on the spine at a minimum.
If you’re most comfortable sleeping on your back, that’s great (unless you’re pregnant—in which case, read on!). “Sleeping on your back is definitely the best position for all body parts, because we’re less likely to twist or compress the nerves,” says Bautch. “Sleeping on your back is definitely the preferred way.”
Just be sure to get a few extra pillows. Place a small one behind your knees, bending them slightly. (If you want to get technical, bend your knees to 135 degrees—the angle prescribed by ergonomist Bart Haex in his book Back and Bed: Ergonomic Aspects of Sleeping.) Find a pillow that keeps your neck and shoulders in line with your ears and hips, which will keep your spine straight all the way to the base of your skull.
The lateral sleeping position—lying on your side—can also be a good sleeping position for back pain. Pull your knees a bit upward toward your torso to maintain stability. The right mattress also goes a long way here. You want your hip and shoulder to sink into the mattress just enough to keep your spine straight. Perfect the lateral sleeping position by placing a firm body pillow between your knees.
“If you sleep on your side, think about if you looked down and said, ‘Okay, here’s how wide my knees are when I’m standing normally,’” Bautch says. “I’m a big fan of body pillows. You put them between your knees, from your ankles to your knees, all the way to your arms. You hug them, and you have a tendency to keep your arms and legs in the right place.”
Try to align your hips, shoulders, and ears. If you can’t, adjust your pillows. “From your shoulders, you could draw a line on your spine and it would go all the way to your pelvis,” Bautch says. “And if I drew that line, it would continue right through between your knees and all the way to your ankle. That’s how I’d want to try to sleep.”
Long story short: The best sleeping positions for back pain are supine (on your back) and lateral (on your side). Use pillows to support parts of your body that aren’t sinking into the mattress, and to keep your body stable during sleep. Remember, you won’t be awake to purposely adjust.
And if that back pain gets worse, or doesn’t go away? Talk to your doctor.
Best Sleeping Positions for Neck Pain
Neck pain and your sleeping position are strongly associated with one another. In fact, poor sleeping positions can not only lead to unhealthy sleep, but to musculoskeletal disorders in the neck and shoulders as well. You want the neck to remain straight, lying in the neutral posture. Unfortunately, that’s not something most contemporary pillows are built for.
“Most pillows are biggest in the middle and smallest at the edge,” says Bautch. “But they really need to be bigger on the edge and smaller in the middle because our head needs to sink down so we stay neutral all the time.”
If you have a conventional pillow, you probably need more neck support to get truly healthy sleep, especially if you sleep on your side. Your pillow alone is unlikely to keep your neck and spine aligned, which means it can exacerbate neck pain rather than providing relief.
Bautch suggests you modify your pillow. “Roll up a towel or something. You need to get an edge. The edge needs to be more supportive than the middle.”
Again, sleeping on your back is the best sleeping position to keep your body in a neutral position. If you can drift off on your back (and don’t snore, especially if you’re sleeping with your boo), you won’t go wrong with that sleeping position. Your neck will thank you.
Best Sleeping Positions for Digestion
Everyone knows they’re not supposed to eat just before bed, but many people do it anyway. Maybe you worked late and got home starving. Maybe dinner was just so satisfying that it put you into a food coma and bedtime became inevitable. No matter what happened, your sleeping position can determine how well your body is able to digest that late-night meal.
Figuring out your best sleeping position is particularly important if you’re prone to heartburn or acid reflux. The gold standard that doctors recommend for people with gastroesophageal reflux disease (GERD) is to raise the head of the bed with six- to eight-inch tall blocks. Extra pillows just won’t cut it according to “Effect of Bed Head Elevation During Sleep in Symptomatic Patients of Nocturnal Gastroesophageal Reflux”—a study published in the Journal of Gastroenterology and Hepatology in 2012—because they may only lift the head and shoulders. Besides, you might just roll off the pillows in your sleep.
If you’re just looking for relief from an overfull stomach, though, and you don’t want to break out the wood blocks, try sleeping on your left side, which is considered the best sleeping position for digestion. Just be sure not to lie on your right side. A major study found that reflux was significantly worse in healthy subjects when they lay on their right sides rather than their left.
Researchers fed 10 subjects sausage-and-egg biscuits and coffee, then had half of them lie on their left sides and half on their right. The latter group suffered more acid exposure and more episodes of reflux. The takeaway? Next time you overindulge just before bed, try lying on your left side. Just don’t forget that pillow between your knees.
Best Sleeping Positions for Pregnancy
Expecting mothers develop sleep disorders frequently, which isn’t completely surprising, considering the vast range of hormonal, physical, and emotional changes that accompany pregnancy. Sleeping in the best position is, again, one factor among many. If poor sleep is routinely affecting your quality of life during pregnancy, you’re best off speaking with your OB-GYN.
That said, the American Pregnancy Association says sleeping on your back is one sleeping position you should definitely avoid during pregnancy since it can cause a decrease in both maternal and and fetal circulation. They also advise against sleeping on your stomach, because, well, you’re a little too big for that.
Citing the work of OB-GYN Glade Curtis, the Association says that the best sleeping position for pregnant women is on their left sides, keeping their legs and knees bent. Placing a pillow under the abdomen can improve comfort in the last trimester. If you have hip pain, again, try placing a pillow between your knees. Try to get as much sleep as you can now, mama!