What’s the Best Sleeping Position?

We spend one-third of our lives sleeping, so maintaining proper posture in bed is vital. Sleeping position impacts sleep quality, which in turn affects stress levels, metabolism, immune system, mood, and more.

Side and back sleeping are the healthiest sleeping positions because they keep the spine neutral, helping sleepers wake up pain-free. In our article, we’ll go over the most common sleeping positions, how they impact your health, and what type of mattress you should use based on your sleeping position.

Why Does Your Sleeping Position Matter?

Bad posture may contribute to back and neck pain, fatigue, headaches, heartburn, poor blood circulation, wrinkles and acne, and sleep apnea. Also, if you have chronic back pain or other medical conditions, the right sleeping position may reduce your symptoms, while other positions may worsen them.

Each sleeping position has its benefits and drawbacks, but keep your physical health in mind when choosing how you sleep.

Back Sleeping

Back sleeping is considered the healthiest sleeping position for the average person, but it’s not the most popular. The two common variations of back sleeping are the supine position (keeping your arms at your sides and your legs together) and the starfish position (spreading your legs and resting your arms on either side of your head).

“Sleeping on your back supports your spine, minimizes acid flux, and reduces compression to the hip, shoulder, and knee joints,” says Dr. Bhavik Sheth, Physical Therapist. You’re also safe from getting wrinkles or acne since you’re not resting your face on a pillow, a common issue with both side and stomach sleeping.

While back sleeping is healthy for most people, it’s not recommended for sleepers who snore or have obstructive sleep apnea. On your back, your tongue and jaw relax, blocking your breathing. Elevating your head and upper body with a wedge pillow or adjustable bed frame opens your airways and can relieve symptoms. We also recommend those with breathing problems switch to side-sleeping.

For people who struggle with lower back pain, back sleeping might put even more stress on the lumbar spine. “Sleeping with a pillow under the knees relieves back pain because your spine is better aligned and there’s less pressure on your lumbar spine and lower back muscles,” says Dr. Bhavik Sheth, Physical Therapist. Avoid sleeping with your head turned to the side when back sleeping as it can result in cramping, achiness, and stiffness.

Side Sleeping

Most people sleep on their sides in the log position, with their arms down and close to the body. Side sleeping is beneficial for reducing back pain, lowering heartburn and acid reflux, and aiding digestion. You’re also less likely to snore or aggravate your sleep apnea when side sleeping.

A 2015 study found side sleeping helps your brain clear out interstitial waste faster than other sleeping positions, potentially reducing the risk of developing neurological diseases such as Alzheimer’s or Parkinson’s.

Side sleeping can cause stiff shoulders and hips, jaw tightness, and it contributes to wrinkles and acne on the side you’re resting upon. Placing a pillow between your knees while you sleep on your side prevents back and hip pain and stiffness, though it does little for jaw tightness, wrinkles, or acne.

The fetal position is the most popular variation of side sleeping. Bringing your knees in towards your chest and curling your torso inwards opens the space between your vertebrae and lessens any pressure on your spine.

The fetal position is useful for pregnant women, those who snore or have sleep apnea, and back pain sufferers. For pregnant women, it’s better to lay on the left side to prevent the uterus from pressing against the liver and causing discomfort.

However, curling up too tightly can increase the rounding of your back, place unwanted pressure on your abdomen, and restrict deep breathing. Also, if you suffer from joint pain or stiffness, the fetal position can leave you sore. Slightly straighten your body and extend your legs a bit to prevent issues and pain from developing.

Stomach Sleeping

Stomach sleeping is the worst sleeping position for some people, as it can cause neck and back pain, strain muscles and joints, and cause stiffness. Some common types of stomach sleeping are the freefall position (your hands on either side of your pillow) and the skydiver position (head to the side with your hands behind your pillow).

While we recommend transitioning away from stomach sleeping, if it’s difficult for you to switch positions, try placing a pillow under your hips to protect your back and prevent pain.

The Right Mattress and Pillows for Every Sleeping Position

Unsupportive mattresses and pillows potentially strain your body and, over time, can lead to chronic pain and stiffness. Using the correct pillow and mattress for your sleeping position ensures your spine and back are neutral and you aren’t unintentionally hurting yourself. Let’s take a look at the best pillows lofts (pillow thickness) and mattress firmnesses suited for every sleeping position.

Back Sleepers

As a back sleeper, you don’t need the same conforming materials as side sleepers nor as much firmness as stomach sleepers, so a medium to medium-firm mattress is best. With a medium to medium-firm mattress, the back and spine are neutral without sinking in or curving too much.

A medium loft pillow (4 to 5 inches) provides just enough height to keep your head neutral with your spine. Thicker pillows can cause your neck to curl in towards your chest and cause cramping and discomfort.

Side Sleepers

Side sleepers are vulnerable to developing achy pressure points in their shoulders and hips since both body parts are wide and in direct contact with a mattress. We suggest soft to medium mattresses for side sleepers since they properly cradle the hips and shoulders and align the spine without causing pressure.

There’s a large space between side and fetal sleepers’ heads and the mattress, so they should opt for a high-loft pillow (5 to 7 inches) to prevent their heads from curving too far to the side.

Stomach Sleepers

Medium-firm to firm mattresses work best for stomach sleepers so the spine stays neutral. An overly soft mattress can cause stomach sleepers to sink, curving the back and causing pain.

Stomach sleepers should use a thin (less than 3 inches thick) pillow or no pillow at all. Too thick of a pillow can curve the head and neck backward.

If you prefer sleeping facedown, use a small, firm pillow just under your forehead so your neck is straight and you still have breathing room. It’s also a good idea to place a pillow under the hips to relieve pressure on your lumbar spine.

FAQs

Should you sleep with your shoulders on or off the pillow?

Pillows fill the gap between your head, shoulders, and the mattress. They support and align your head and neck, but not your shoulders. If your shoulders are on your pillow, your head and neck are most likely not adequately supported and can result in pain and stiffness. With any sleeping position, your shoulders should be off of your pillow.

Why do I keep waking up with a dead arm?

The “pins and needles,” numb feeling in your arm is known as capillary crush and occurs when there’s too much pressure on your blood vessels, worsening your blood circulation. Some potential causes of capillary crush include carpal tunnel, thoracic outlet syndrome (TOS), nerve damage, vitamin B12 deficiency, certain medications, and an awkward sleeping position.

If you believe a health condition is causing your dead arm, speak to your doctor or physical therapist for assistance. Otherwise, switching to a sleeping position where your arms aren’t compressed can eliminate the numbness.

How can I improve my circulation while sleeping?

Diabetes, arterial constrictions, heart disease, obesity, and being bedridden are common causes of poor circulation and can lead to cramping, numbness, and pain in your hands and feet.

Elevate your legs to prevent blood from pooling in them and avoid compressing any of your body parts, such as placing your arms under your pillow or under your head. Always use a supportive mattress and pillows to keep your spine and body aligned and prevent pressure buildup.

How can I change my sleeping position?

When you’re changing your sleeping position, consistently lay in your new position. If you find yourself rolling into your prior sleeping position when you wake up, train your body by restricting its movement—put body pillows on either side of your body to hold yourself in place. While switching positions can feel awkward at first, your body will adjust eventually.

Is it better to sleep with no pillow?

Pillows are used to keep your head and neck aligned with your spine and you need to use one for most sleeping positions. However, stomach sleepers can comfortably sleep without a pillow as it prevents their necks from overextending.

Conclusion

Side and back sleeping are the healthiest sleeping positions. They’re excellent for spine health, relieving physical pain, and overall comfort. Both are good options, though based on your specific needs—such as if you’re pregnant or struggle with acid reflux—your sleeping position is going to vary. With any sleeping position, use a supportive mattress and pillows to promote spinal alignment, reduce pressure buildup, and prevent feeling “stuck.”