What position is best... for sleeping?

Dear Alice,

Is there a "correct" way to sleep? Position wise? And if so, is it possible to change your current sleep habits to conform to the correct way?

Waking up in fetal position

Dear Waking up in fetal position,

The position you find yourself waking up in is a good one. The fetal position (or resting on your side with your head slightly forward, your back slightly curved, and one or both knees brought up toward your chest) removes pressure from the spine and allows the organs to spread themselves out as you rest. This position also allows for easy breathing, so your body gets plenty of oxygen throughout the night. A firm pillow under your head or neck keeps weight off your shoulders, and a flat pillow between your knees can help keep your back in good alignment.

According to studies conducted by medical professionals and sleep specialists, it appears that the optimal sleeping positions are either sleeping on your back or on your side. This is because these positions reduce stress on the spine during the night. For back sleepers, a firm pillow underneath the head will maintain the curve of your neck while you sleep, but if sleeping on your back causes back pain, a small pillow under the knees may help relieve it and keep your spine aligned through the night. One caveat is that if you have a history of sleep apnea or snoring, sleeping on your back can actually exacerbate snoring and sleep apnea symptoms.

Since you described that you're a side sleeper, you may want to be mindful of the positioning of your chin at night. If you tuck your chin down when you're in the fetal position, it creates tension on your head and neck. That's why if you're a side sleeper, it's recommended that you keep your chin straight with your shoulders in alignment with the holes of your ears. Additionally, to maintain the alignment of your spine throughout the night, you may want to place a small pillow between your knees to relieve pressure from this area. 

In contrast, sleeping on your stomach can cause your neck to be extended backwards, which can lead to discomfort in your spine and neck as it becomes compressed during the night. Often times stomach sleepers use pillows that position their head too high, so if you're committed to sleeping on your stomach, you may want to look for a flat pillow to sleep on (or no pillow at all!). Sleeping on your stomach can also place pressure on your lungs, making it harder to breathe through the night. For stomach sleepers that like to bring one leg up during the night, this position can lead to back pain in the morning due to the rotation of your hips and lower back. Sleeping with your arms above your head, wrapped around a pillow, for example, can pull blood away from the heart, interfering with circulation.

Almost everyone shifts positions several times while sleeping, so the position you start in most likely won't be the one you wake up in. To make sure that you don't toss and turn too much during the night, use firm pillows (and not too many of 'em... just one or two should be fine), and sleep on a mattress that isn't saggy and worn out (experts recommend you sleep on the firmest mattress with which you're comfortable).

In the context of sleeping correctly, perhaps it's okay to sleep just the way you do now, as long as you've been waking up feeling comfortable and well-rested. Accepting that, or not worrying about having to sleep "right," may help you snooze even better. However, if you find yourself waking up in discomfort or pain, or are unable to get a good night's rest, a talk with your health care provider would make sense.

Sweet dreams,

Last updated Oct 28, 2022
Originally published Nov 21, 2003