Is Your Sleep Position Helping Or Hurting Your Health?
by Dr. Marci L. Hardy, PhD
When you are awake, your body uses energy to fuel your movements throughout the day. During sleep, your body adjusts and shifts to maintenance mode, doing the important work of repairing and healing itself. However, the quality of a night’s sleep can vary, meaning not all sleep is equal in healing value. Did you know that the position in which you sleep may be one of the factors impacting the quality of your sleep and thus your health?
UNDERSTANDING SLEEP POSITION & HEALTH
The most common health problems associated with sleep position include:
Joint pain
Digestion, reflux, and heartburn
Snoring and sleep apnea
Wrinkles
For example, your sleep position may be impacting how your joints line up with each other, known as your body’s alignment. Having poor alignment may increase pressure on your joints or internal organs. Repeatedly sleeping in the same position may create repetition that compromises or aggravates existing medical conditions or physical injuries. Your sleep position may even be causing new problems that can impact your health in the future, such as unsupported breast tissue or compressed skin.
HOW MUCH TIME ARE YOU IN BED?
If you are one of the lucky people getting the recommended seven to nine hours of sleep each night, you will be spending about one-third of your life sleeping. Because you spend so much time sleeping, your sleep position has a great deal of influence on your life. It may be impacting the quality of your sleep and enhancing or reducing the potential health benefits of your sleep.
THE INFLUENCE OF TIME IN ONE POSITION
Before we dig into the impact of your body position during sleep, it may be helpful to first think of another area in your life that you spend a significant amount of time—your job. A great deal of research has been done on body position, repetitive actions, and how they impact your health. For example, in the workplace, there is research weighing the negative impacts versus health benefits of:
Using a seated desk versus a standing desk
Elevating your computer screen versus looking down at a laptop
Engaging in physically demanding, but changing tasks versus stationary, small repetitive movement positions
In fact, the Occupational Safety & Health Association (OSHA) provides guidelines to help protect your health in the workplace so as to minimize your risk and improve working conditions. Their recommendations are based on ergonomics, which basically means fitting the way a job is performed to the person doing the job. The OSHA ergonomic guidelines are intended to reduce muscle fatigue, increase productivity, and reduce the frequency and intensity of work-related musculoskeletal disorders, which translates to reducing the risk for injury. When someone does an ergonomic assessment of your job or workstation, they find the best position for you to do your job that will have the lowest health risk for your body. This may mean adjusting how you do your job or the position of components of your job, like raising a chair or computer screen height, or putting a pad on the surface where you stand. Essentially, they are trying to create a “best fit” for your body and that job.
DO WE NEED AN ERGONOMIC ASSESSMENT OF OUR OTHER JOB… SLEEP?
Closely following the amount of time you spend at work is the amount of time you spend sleeping—likely the next largest chunk of your day. Your body position while sleeping, and the support your body receives from your pillow and mattress, may each be impacting your health.
For example, you likely do not spend the entire time you are sleeping in one single sleep position, even though you still likely have a primary or preferred sleep position. People tend to move throughout the night. The question is whether or not your sleeping positions are negatively impacting your quality of sleep and/or your overall health. Like the ergonomics of a job, your ideal sleep position is likely dependent on many factors and likely not the same as your spouse’s or sibling’s ergonomically ideal or “best fit” sleep position.
HOW DO YOU DETERMINE YOUR “BEST FIT” SLEEP POSITION?
In order to find your “best fit” sleep position, you must first understand the pros and cons of each sleep position. The four primary sleep positions are:
FETAL POSITION
DESCRIPTION
When you were growing inside your mother’s womb, you were scrunched into a ball, laying on your side. Likewise, the fetal sleeping position outside of the womb occurs when you lie on your side and scrunch your body forward by rounding your neck and back and bending your legs which results in your body making a C shape. Some people will progress further and hug their knees all the way up to their chest in the fetal position.
PROS
The more relaxed fetal position can be comfortable for some women in late pregnancy, as the other positions become more difficult due to their growing baby. For example, a pregnant woman may want to put a pillow between her knees for added hip support in bed. If you are pregnant, you may want to ask your healthcare provider if the fetal sleeping position would be comfortable and healthy for you.
CONS
If you already suffer from neck or back pain, the fetal position is likely to make it worse. The forward bend of the spine while sleeping in the fetal position may strain your neck and back and compromise your circulation and breathing. The knee bend in the fetal position may also cause knee pain if you have arthritis. If you are a more extreme fetal position sleeper with arthritic hips, and you hug your knees to your chest, this may cause hip pain. In addition, one side of your face is compressed into the pillow in the fetal position, increasing your risk of developing premature wrinkles.
STOMACH POSITION
DESCRIPTION
Sleeping in the prone or stomach position involves lying with the chest side of your body directly against the mattress. This sleep position usually involves twisting your head to one side for easier breathing. When sleeping on your stomach, your arm position can vary from: beside your body, smashed beneath your body, elevated near your shoulders, or elevated above your head.
PROS
There are mostly cons for the stomach sleeping position. However, the one positive is that, for some people with snoring problems but no neck or back issues, the stomach position may result in fewer breathing problems than a back lying sleep position.
CONS
Sleeping on your stomach means that either your face is smashed into the mattress—which makes breathing difficult—or, more likely, you are sleeping with your head turned to one side. This position, where the rest of your body is flat combined with the side twist of your head, can strain your neck, spine, and lower back. Both the face-forward and head-twisting stomach positions put pressure on at least one side of your face, which increases your risk for premature wrinkles. Moreover, each of the various arm positions in the stomach sleeping position may result in different issues with circulation and/or joint pain. Finally, older adults rarely sleep on their stomachs: likely because this sleeping position means the weight of your body (plus gravity) pushes down on your lungs, requiring extra effort for breathing.
SIDE SLEEPING POSITION
DESCRIPTION
The side sleeping position is the most common sleeping position among adults. Research suggests this may be due to the decreased flexibility of the spine with age. Side sleeping involves stacking your hips and shoulders on top of each other, with just one side of your body making contact with your mattress. A true side sleeping position differs from the fetal position in that you are not curled inward in a C shape. Your head and neck typically stay in relative alignment in the side sleeping position. Also, the side sleeping position can be subdivided into two positions: left side or right side.
PROS
Researchers have found that, for people with carpal tunnel syndrome, sleeping on their side significantly reduced the frequency of burning or prickling sensations in their hands. When you are sleeping on your left side, your body also uses gravity to help support digestion. If you suffer from Gastrointestinal Esophageal Reflux Disorder (GERD), research shows that left-side sleeping is preferred for reducing the frequency and intensity of reflux. Research on animals shows that side sleeping may be beneficial for your brain health.
CONS
Side sleeping puts pressure on the joint that is making primary contact with the bed. Researchers have found an association over time between side sleeping and pain in the shoulder that makes direct contact with the mattress. Your spine may also not be fully supported in a side sleeping position—hence, you may want to hug a pillow or stuffed animal to your chest when you sleep on your side, and/or also place one between your knees to help with spinal alignment. Side sleeping does subject your facial tissue to shear, compression, and tensile mechanical forces, which are believed to lead to wrinkles.
BACK SLEEPING POSITION
DESCRIPTION
Lying flat with your face to the ceiling is known as the supine or back sleeping position. In the back sleeping position, your arm position may vary from by your sides to on your chest or near/above your head.
PROS
Sleeping on your back is the best position for avoiding wrinkles. The hair on the back of your head is making contact with your pillow and/or mattress as opposed to your face. That means the skin on your face isn’t subjected to tugging or twisting during the night. Also, a woman’s ribcage supports her breasts during the night while sleeping in the back position. This support means there is less gravitational pull on the ligaments in the breasts over time, compared to other sleep positions. The back sleep position evenly distributes your weight across your body, reducing pressure on any single joint. Back sleeping also involves keeping the spine in a relatively straight line, ensuring good alignment of the head, neck, and spine.
CONS
According to one observational study, people who suffer from dry eyes may experience greater difficulties when sleeping on their back than if they were to sleep on their side or stomach. Sleeping on your back is not recommended during the second and third trimesters of pregnancy. A growing fetus creates pressure that may interfere with breathing and circulation to both your body and the growing baby’s body, which may then impact blood pressure. In addition, researchers found a 3.7-fold increase in late-term stillbirths among pregnant women who went to sleep on their backs. Individuals with Parkinson’s disease are more prone to the back sleeping position, which is associated with more sleep-disordered breathing and daytime sleepiness. In addition, your tongue can fall back in your mouth and block your airway, which can lead to increased snoring.
Finally, you are more likely to suffer from reflux or GERD in a back sleeping position.
YOUR ERGONOMIC SLEEP ASSESSMENT
Your ergonomic or “best fit” sleep position is likely dependent on your unique health factors, including:
Snoring
Sleep apnea
Digestive health and reflux
Pregnancy
Age
Localized joint injury or pain
Arthritis
Back pain
Your sleep position may even be fine if you are simply sleeping on a different mattress that is more supportive of your body and its unique needs. In a research study, individuals with back pain and stiffness were able to reduce their pain index over time by choosing a new mattress that directly aligned with their sleep position. If you find yourself feeling tired after what should have been a full night’s sleep of seven to nine hours, or if you frequently wake up in pain, you may want to speak to your primary care physician about your sleep position and sleep health.
You don’t have to continue to suffer from poor sleep that may be negatively impacting your health. The good news is you can retrain your body to sleep in a different position. Plus, Brooklyn Bedding offers a variety of mattresses specifically made to address the unique needs of individual sleepers. Their sleep specialists are available to help you find the “best fit” mattress for your sleep profile.
