Best sleep position

By Jill Levy

Did you know that sleeping in certain positions may make it more likely that you’ll deal with issues such as back and neck pain, daytime drowsiness, sleep apnea and headaches? It’s true — not just how much, but the way you sleep can really impact everything from muscle function and digestion, to skin and cognitive health.

While most people report favoring sleeping on their side (specifically in the “fetal position”), some find that they prefer to doze off on their backs or stomachs.

It may be true that back sleeping is most often the position recommended by experts such as chiropractors in order to prevent aches and pains, but is sleeping in other positions necessarily a problem if it feels most comfortable?

Below we’ll look at the pros and cons of sleeping in various positions, along with recommendations that may help you get the best possible sleep depending on your current situation.

Benefits of Different Sleep Positions

Whether on your side, stomach, back or a combination of all three, here’s what we generally know about the benefits of different sleep positions:

1. Side Sleeping

Benefits: Side sleeping (this includes the “fetal position” in which your torso is hunched and your knees are bent) is considered a “brain and spine friendly” position because it may help support waste-clearing via the brain’s glymphatic pathway. This is thought to translate to support for healthy cognitive function, although there’s obviously more to this story than how someone sleeps. 

Other potential benefits of side sleeping include helping to fight sleep apnea symptoms, snoring, acid reflux, and potentially neck pain and back pains (for some people, but not others).

Considerations: If side sleeping hurts one side of your body, or your hips, try placing a small pillow between your knees or legs for extra cushion and support. This especially works well for most pregnant women who may be uncomfortable on their backs and need to avoid laying on their stomachs.

While on your side, try to straighten out your body as much as you can in order to avoid curling up too tightly in the fetal position, which may cause aches and make it difficult to breathe normally.

Best Pillow Type for the Position: The goal is to prevent your neck from arching and straining too much, so choose a firmish pillow that helps keep your spine elongated and feels most comfortable on your neck.

Ideally, choose an organic cotton pillow that is firm enough to support your head while also high enough to keep it in a neutral position. If you deal with neck pain, a millet or buckwheat pillow can be helpful for contouring to your head and neck.

Who Should Try It? Side sleeping is considered best for people looking to support normal breathing while sleeping and those who want to limit snoring. It’s also ideal for pregnant women and many people with joint issues or aches.

Who Should Avoid: If you prefer not to have your face pressed against a pillow, perhaps because of skin issues or the risk for worsening skin issues, you may want to skip side sleeping. Sleeping on your back might be a better option is this position aggravates your spine or contributes to other discomfort.

2. Stomach Sleeping

Benefits: This position can be comforting and relaxing for some people (leading to deep sleep), may help control back pain for some, and can limit snoring. 

Considerations: Some find that stomach sleeping worsens aches and pains such as neck discomfort, can trigger stomach pains or digestive issues, and may also lead to tingling and numbness. This is because the spine is not elongated and the head is faced towards one direction for long periods of time, which can easily result in a stiff neck. 

If you prefer this position, ideally try to change positions throughout the night instead of strictly sleeping on your belly all night long, especially facing towards only one side.

Best Pillow Type for the Position: If you do sleep on your stomach you’ll want to use a thin pillow that won’t cause your head to be lifted and twisted too much. The best option is one that’s made with natural material, low, flat and semi firm.

Some people who like stomach sleeping even prefer facing straight down with their forehead touching the pillow, which can help control neck pains. Just be sure that there’s enough space between your face and the pillow for you to breathe properly. 

Who Should Try It? This position may work best for younger people and children who find this position to be soothing. It can also limit wakefulness in some people because it tends to be calming.

Who Should Avoid: It’s generally recommended that most adults avoid stomach sleeping if they can, due to risk for aggravating the spine/neck, unless it leads to no issues such as pains. After the first trimester pregnant women are also typically advised to skip stomach sleeping. 

3. Back Sleeping

Benefits: This is the position that most experts recommend sleeping in, since it can help to keep your head, neck, and spine in a neutral position while limiting pressure on joints. It may also help to limit acid reflux symptoms and other forms of indigestion, as well as back and hip pains. 

Considerations: This position is a good strategy for warding off acid reflux; just be sure to use a pillow that elevates and supports your head enough. Ultimately you should aim for your neck to stay in alignment with your spine, so try to avoid being in a crooked position.

Best Pillow Type for the Position: You’ll want to use a pillow big enough to keep your head elevated so that your chest is slightly higher than your stomach. This is ideal for supporting digestion and reducing heartburn/reflux.

Who Should Try It? People with digestive issues, back pain, neck pain and hip pain may all benefit from sleeping in this position. It can also work well for some pregnant women.

Who Should Avoid: Those who have sleep apnea should avoid back sleeping since it may worsen symptoms. While snoring isn’t necessarily dangerous, back sleeping might also make snoring worse.

Jill Levy has been with the Dr. Axe and Ancient Nutrition team for five years. She completed her undergraduate degree in Psychology from Fairfield University, followed by a certification as a Holistic Health Coach from the Institute for Integrative Nutrition. Jill takes a “non-diet” approach to health and really enjoys teaching others about mindful eating, intuitive eating and the benefits of eating real foods.

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