Best Sleeping Position for Lower Back Pain, Sleep Apnea, and More
You probably already know sleep is an important part of overall well-being and there are a lot of factors that contribute to how well you sleep. One of the most important factors is your sleep position. According to Cheryl Memmini, a clinical sleep educator with Northwestern Medicine Sleep Services in Illinois, whether you lie on your back, side, or belly in bed can impact both how deeply you sleep at night and how you feel the next day.
So, that begs the question: What is the best sleep position? Unfortunately, there's no one ideal sleep position to rule them all, says Jennifer Y. So, MD, a pulmonologist and the medical director of the University of Maryland Sleep Laboratory. "Depending on someone's stage of life or individual health conditions, the best sleep position can vary," Dr. So tells Health.
Curious about the best sleep position for you and your individual needs? Here's what sleep specialists have to say.
When to sleep on your side
Two types of people particularly benefit from sleeping on their sides. According to Alon Avidan, MD, MPH, the head of UCLA's Sleep Disorder Center, people with obstructive sleep apnea should sleep on their sides to keep their airways open. Essentially, back-sleeping creates a gravitational pull on the tongue, which can block the airway. "When you're on your side, you partially remove that obstruction," Dr. Avidan tells Health. People who persistently snore but don't have sleep apnea might also find they sleep better (and more quietly) on their sides.
Dr. So also encourages pregnant people, especially those in their second or third trimesters, to sleep on their sides—specifically, the left side, which she says can improve circulation to the placenta. Sleeping on the back can compress veins and blood vessels within the belly and can disrupt blood flow, so it's best to avoid back-sleeping while pregnant.
If you sleep on your side, try to avoid the fetal position. "You're essentially curling your back up and pulling everything in, which can cause pressure in your back and restrict your breathing," says Memmini.
Vishesh K. Kapur, MD, MPH, director of Sleep Medicine at UW Medicine and a professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine with the University of Washington School of Medicine, adds that it's important to choose a thicker pillow to support your head so it doesn't drop down when you lie on your side.
When to sleep on your back
If you don't have breathing problems and you're not pregnant, it's perfectly fine to sleep on your back. In fact, Dr. Yo says people with back pain or any type of spine problem may benefit from back-sleeping. "These individuals may experience that sleeping on their backs leads to less back pain because it allows for more natural alignment of the spine," she says.
There's one exception: Memmini says people with lower back problems may find back-sleeping to exacerbate pain. In that case, it can be helpful to sleep with a pillow under your knees so your legs aren't pulling down.
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Sleeping on your back can also be helpful for people with acid reflux: Memmini says lying on a pillow elevates the head, which can prevent contents of the stomach from moving up the esophagus. Dr. Yo recommends back-sleeping for people with sinus congestion, too, because it prevents mucus from clogging one side or the other. If you are congested or you're prone to acid reflux, she says it may help to prop up the head of your bed up a bit, too.
When to sleep on your stomach
Dr. Kapur says sleeping on your stomach can help with breathing issues related to sleep apnea or snoring, as long as your neck position is neutral. "Resistance to breathing would be less when your neck position is conducive to airflow," he says.
But this position may not be ideal for someone prone to headaches or neck pain, which is why Memmini generally recommends against it. This position can cause people to over-arch their neck, which can result in headaches," she says. Plus, she says, people tend to be more restless on their stomachs, so they don't sleep as well.
If you're a stomach sleeper and can't change your tune, she recommends using a very soft pillow or no pillow at all to keep your neck in a more neutral position.
How to change your sleep position
As Memmini emphasizes, how you sleep can impact your quality of sleep and your quality of life. So in some cases, it may be worth trying to change your position—although she adds that may not come easily, because most people condition themselves to prefer a certain way. "It can take months to do it, and you have to do it in a way where you can't move," she says.
For example, she says people who shouldn't sleep on their back for medical reasons sometimes sew tennis balls in the back of the shirts they wear to bed so they roll onto their sides when they land on their backs.
If you want to change from your stomach to your side, she suggests investing in a large, firm body pillow, which you can lean into without rolling all the way onto your belly. And if you notice yourself snoring in one position more than another, Dr. Avidan says a designated snoring pillow can help keep you in the same position overnight.
For those without any medical conditions that make a particular sleep position necessary, the best way to tell if your sleep position is working for you is how you feel in the morning and throughout the next day. "If everything hurts in the morning or you're exhausted, then your sleep position wasn't a good idea," says Memmini.
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