What’s the Best Position to Sleep?

What’s the Best Position to Sleep?

Probably the second most common question I get asked is what the best way to sleep is. (The first incidentally is what to do for back pain!).

Absence of any pain or injury here is my answer:

Side-lying is most likely the best position for most people. When sleeping side-lying, keep a pillow between your legs so that your knees are shoulder-width apart. You should not be sleeping directly on your shoulder, the shoulder blade should be contacting the mattress and the shoulder slightly pulled out from underneath your body.

The most important thing for your upper body and spine is that your head is on the pillow but your shoulders are NOT on the pillow. The pillow should be tall enough that your head should be in line with your body. This means the neck should not dip downwards or raise too high, but stay in the same plane as your body as it does if you are standing in good posture. To make this happen, you will need the thickness of the pillow to coincide with your own body physique.

Second, since there is an arch in the neck just like there is an arch in the foot, that arch needs to be supported fully. You can spend money on an orthopedic pillow that already has an s-shape or curve in it or you can scrunch up the pillow under the neck arch so it cushions the curve perfectly. Then the rest of the pillow sits under the head to keep it inline with the body. This position is not recommended, however if you have pain on the outside of your hip or shoulder (unless you lay on the opposite side). Some of my favorite pillows are made by Sleep Innovations and are so much cheaper and so much better than Tempurpedic brand. Those are generally over expensive and squish down so much that the head ends up being lower than the body and thus not in line. No need to spend the money on these. Get a Sleep Innovations Memory Foam Contour pillow (https://www.amazon.com/Sleep-Innovations-Memory-Contour-Warranty/dp/B0029LHHRC/ref=sr_1_4?ie=UTF8&qid=1520457758&sr=8-4&keywords=sleep+innovations+pillow) or scrunch up the pillow of your choice. We use this pillow sold on Amazon in our office its so good…I also have several at home.

If you must sleep on your back for any reason, the most generally accepted way to do this is to put a pillow or two pillows under the knees (depending on the height of the pillow). The height necessary for you is the height needed to flatten your lower spine arch completely onto the bed. Depending on your spinal curve and the pillow size that may be one or may be two pillows. This position is often best with certain kinds of back pain, or when recovering from shoulder surgery or shoulder pain, or any intervention that forces you to stay on your back.  It is, however the worst for snoring, sleep apnea and lung related issues.

If you must sleep on your stomach alternatively, the pillow must go under your stomach to support your lower spine curve. Again, the thickness of the pillow required depends on how big the curve is in your lower spine. The goal is for the lower spine to be flat, with no arch at all. Generally one pillow is all it takes for most of us to flatten out the spine. However, if you have some lower back pain, most specifically herniated discs,  it may feel better to make the arch reverse rather than flatten, so two pillows under your stomach may be better than one. People who benefit from this position are generally herniated disc sufferers as mentioned or those who cant kick the habit of stomach sleep.  For neck pain and neck herniated discs however, this is the worst position and side-lying is optimal.

For the most part, no matter what position you choose, try  not to raise your arms above your head.

The side-lying position is usually best, but as you can see depending on what ails you, another position could be more comfortable. Consult a therapist for other injuries and issues to find the best way to sleep for you.