Most people have a favorite sleeping position—whether that's lateral (side), stomach, or back. While you may find your chosen position comfortable, some sleep positions can actually aggravate certain health problems.
Body position can have an important impact on sleep, especially if it affects breathing. Certain positions can also lead to neck or back pain. Maternity Nursing Pillow
So what are the best and worst sleep positions? How should you sleep to relieve back or neck pain? This article covers some of the most common sleep positions and why they may (or may not) be a good choice for your specific health needs.
When a person is lying flat on their back, it's called the supine position for sleeping. The legs are usually stretched out in a neutral pose.
Arms may lie flat by the sides of the body. They may be bent with the hands across the chest or stomach. Arms also may be raised above the shoulders with the hands by the face, above or behind the head, or out to the sides.
If you can breathe well during sleep, this may be the best sleep position. The body gets good support from the mattress. With a supportive pillow or cushion placed at the knees, this may reduce pressure on the back and any muscle or joint pain.
Raising the feet above the heart with a cushion can relieve edema (swelling) of the feet and ankles, and reduce the risks of congestive heart failure. This is also the preferred sleeping position for infants (with no pillow or cushion) to reduce the risk of sudden infant death syndrome (SIDS).
Those who have trouble breathing when they sleep may find that lying on the back makes this worse. It also may cause louder snoring in people who snore.
Nose blockages and mouth breathing may allow the lower jaw and tongue to more easily shift back and obstruct the airway. This may lead to sleep apnea, a condition in which pauses in breathing occur while sleeping.
Risks of sleep apnea in this position include:
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In the left side lateral position, a person sleeps with their head and torso on the left side, also known as the lateral position. The arm may be under the body, or slightly forward or stretched out, with the left shoulder touching the bed
The legs may be stacked, with the left leg below. In the curled-up fetal position, the legs are bent and the knees are drawn toward the upper body.
Most people sleeping in this position avoid the problems of supine sleep, and their breathing might be better. It's a good choice for limiting the effects of snoring and sleep apnea.
If a right shoulder or hip is causing pain, this position may feel better. Sleeping on the side can also make "spooning" (lying closely side by side) with a bed partner easier.
Pregnant women may find this position comfortable and choose to place a pillow under their stomach or between their knees. Sleeping like this can ease back pain and relieve any pressure on the bladder.
The left lateral position is not for everyone. When sleeping on the left, the organs in the chest can shift with gravity. The lungs may weigh heavily on the heart.
This increased pressure may affect heart function, adding to the heart strain in heart failure. This may, in turn, mean that the kidneys increase output, causing a need to urinate more during the night.
Pressure on the nerves in the left arm or leg may cause other problems. Sleeping in this position may contribute to shoulder, lower back, and hip pain in the long term.
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In this lateral position, a person sleeps with the head and torso lying on the right side. As before, the arm may be under the body, or maybe slightly forward or extended with some pressure at the right shoulder.
The legs may be stacked, this time with the right leg underneath, or with both knees pulled up toward the body in a fetal position.
As with left lateral sleep, sleeping on the right side avoids the problems of supine sleep. If a hip or other left-sided joint is causing pain, that pain may ease.
With gravity shifting the internal organs to the right, it's the right lung that may feel pressure. This will reduce the lung's ability to fill with air, and this lower volume may cause problems. The lower oxygen levels and the strain on the cardiovascular system can affect people with related health issues.
Pressure on the nerves of the right arm or leg may lead to compression injuries or neuropathy. As with left lateral sleep, long-term sleeping on the right side may cause shoulder, lower back, and right hip pain.
Lying on one’s stomach is the least common way to sleep. In this prone position, the face is typically turned to the side for easier breathing. The arms and hands may be tucked underneath, positioned at one’s side, or stretched out to the sides. The legs are usually held straight.
Sleeping on one's stomach can help a person avoid the problems of supine sleep. It also prevents the slight organ shifts in the chest.
There are comfort benefits too. If the mattress or other surface is not ideal, then lying on the chest, stomach, and "softer" parts of the body may offset that.
Tucking arms close to the body can provide psychological comfort and conserve heat. Prone sleep may also be better for easing chronic muscle and joint pain.
Sleeping on your stomach may lead to neck pain. It may also place some strain on the shoulder and upper back muscles. Pressure on nerves in the arms or hands may lead to problems.
It may be harder to breathe with the body’s weight pressing down on the lungs and limiting the motion of the rib cage and diaphragm , which sits just below the lungs.
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Finally, it is possible to sleep with the head raised above the body. This can be done in a recliner, for example. A sleeping wedge pillow may also raise the head during sleep.
Adjustable beds, including specialized mattresses, can lift the head above the body during sleep. The degree of the angle may vary, but most people who need this will benefit from raising the head by 20 to 30 degrees.
Raising the head during sleep prevents collapse of the airway, and this may diminish the risk of snoring and the problems associated with sleep apnea. If positioned properly, it may also be possible to relieve pain.
It is nearly impossible to change positions during sleep. You can't sleep laterally very well with the head raised at an angle at night, and it's not possible to sleep in a prone position. Any problems with sleeping on your back may still happen, especially if mouth breathing occurs.
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When choosing the best position for sleep, Consider the role of joint pain, sleep apnea, and any other conditions that you have.
Be sure to think about your head and neck as much as the rest of your body. A slightly extended neck may improve breathing.
It is normal to wake from sleep to change position, even if you don't remember it. For the best sleep, allow some flexibility in your sleep positions.
It is possible to be aware of discomfort in your sleep and fix it by moving in the night. Ideally, this will limit any long-term problems caused by a particular sleep position.
Getting a good night's rest is important to health and well-being, but sometimes the position you choose to sleep in can cause or worsen breathing problems (such as sleep apnea), or aggravate back and neck pain. If this is the case, you may want to try to sleep in a different position.
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By Brandon Peters, MD Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.
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