How to Sleep on Your Back

We’ve all had a pang of back pain at least once in our lives, but for some of us, back pain is debilitating.

Back pain can keep you out of work and away from the fun activities you used to enjoy. It can limit you from doing the things you need to do, like cooking, laundry, and even traveling. It’s considered one of the top 10 injuries leading to disability.

Your sleeping position may contribute to the frequency and severity of back pain. Let’s take a look at different sleeping styles and how each affects your spinal health.

Defining Back Pain

Doctors diagnose back pain as either acute, sub-acute, or chronic. Acute back pain is a sudden episode of back pain, while sub-acute back pain continues for a period of time. Chronic back pain might come and go but persists over time.

There are a few risk factors for back pain. One risk factor is called occupational posture. This simply means you might perform posture-challenging tasks while working. Simple positions like sitting, standing, bending, squatting, reaching, or walking can cause pain over time.

Other risk factors for back pain include obesity, height, age, activity levels, and depression. Back pain isn’t considered a disease, but rather a symptom of other medical and physical conditions. Many times, addressing the underlying causes of back pain can lessen your discomfort.

Back Pain and Sleep

Some people experience persistent back pains throughout their day-to-day, while others only experience backaches upon rolling out of bed in the morning. If you fall into either of these camps, changing your sleeping position can help.

Back pain and sleep can exist in an ongoing cycle. If you have existing back pain, you might be getting less sleep because you are being woken by the pain. A recent study found living with chronic pain can cost a person 42 minutes of sleep. Acute pain episodes can cost 14 minutes of sleep.

When you’re not sleeping well, your body doesn’t have time to regenerate as fully as it could at night. Lack of sleep can contribute to back pain because your body doesn’t have time to restore its tissues while you sleep. Pain can keep you up at night, and being up at night can cause you pain.

Many people who suffer from back pain want to know the best sleeping position for their back. Everyone’s body is different, and some positions may be better for you based on your height, weight, or previous injuries.

Another thing to consider is the bed you sleep on. The best mattress for back pain works to keep your hips above your thighs, thus keeping your spine straight.

Best Sleeping Position for Back Pain

Have you ever laid flat on a hard surface and felt an “ahhhhh” feeling in your spine?

If you think about your spine as a line of string running through your head, neck, and back, you can visualize the way your body moves. Sleeping on your back keeps the head, neck, and back aligned as a unit.

Back Sleeping and Sleep Apnea

Back sleeping isn’t best for everyone. Back sleepers who have sleep apnea or who snore are encouraged to switch up their sleeping position. Sleep apnea can be worsened by back sleeping. The tongue can relax and fall into the throat, creating breathing difficulties. People with sleep apnea are encouraged to try side sleeping or try “or sleeping with the head of the bed elevated” says Dr. Bhavik Sheth, Physical Therapist.

For more information on side sleeping, refer to our article on the best mattress for side sleepers.

Best Sleeping Position During Pregnancy

Pregnant women should also be cautioned against back sleeping. Toward the end of your pregnancy, it might be the most comfortable position. Yet, it’s not recommended because the weight of a pregnant tummy can put too much pressure on your circulatory system. Pregnant women are encouraged to sleep on their left side to maximize blood flow.

Worst Sleeping Position for Lower Back Pain

The great majority of people aren’t back sleepers — 74% of people are side sleepers. Only 16% of people are stomach sleepers.

People who snore or have sleep apnea are encouraged not to sleep on their backs. So, some people might mistakenly believe stomach sleeping is the ideal sleep position. Yet, stomach sleeping can leave you waking with piercing neck and back pains.

Sleeping on your stomach puts unnatural pressure on your spine. It forces your neck to rotate to either the right or left side. Sleeping in this position for hours compromises the flow of blood, lymph, and spinal fluid and may cause pain in the joints.

Stomach sleeping also puts the majority of your body weight on the middle of your back. This applies pressure to the natural curve of your lower back, causing it to bend more than it should.

If you just can’t come around to back sleeping, side sleeping or sleeping in the fetal position is preferable to stomach sleeping. Side sleepers who can’t make the change to back sleeping are encouraged to use a pillow between their knees. Placing a pillow under your knees will align the hip flexors and neutralize the spine. Snorers should sleep on their side, as back sleeping can make snoring worse.

How to Sleep on Your Back

Most back sleepers will tell you back sleeping didn’t feel totally natural at first. Only 10% of people sleep on their backs, and most have had to train themselves to sleep comfortably this way. Finding the best mattress for your particular needs is an easy way to make transitioning to back sleeping more natural.

Because sleeping on your back may alleviate your back pain, you may want to consider adjusting your sleep position.

Back sleeping also has other health benefits like preventing heartburn and acid reflux. Dermatologists even recommend back sleeping for wrinkle reduction. Back sleeping doesn’t put any unnecessary pressure on the face while you sleep, so it won’t cause creases which lead to wrinkles. Back sleeping is a good choice for people with colds and allergies because it promotes drainage of the fluids in the sinuses.

Pillows for Back Sleeping

The pillow you use while back sleeping should be firm enough to support the natural curve of your neck. If it props your neck at an angle or allows your head to fall back, you might wake up with neck pain or shoulder pain. The pillow should allow you to swap from back sleeping to side sleeping, and from the right side to left side. Even though you may sleep predominantly on your back, most people don’t sleep in the same position all night.

While sleeping on your back, you can use a small pillow to prop the underside of your knees. In addition to feeling comfortable, the knee pillow will alleviate some stress on the low back and spine. It will also support the lower back’s natural curve.

Frequently Asked Questions

What is the healthiest way to sleep?

Sleeping on your back may be healthier for your spine and sleeping on your right side is healthy for your heart. Stomach sleeping is the only sleeping position that is considered unhealthy and that is because it’s very stressful on your spine. When you sleep on your stomach, you also have to twist your head to the side to breathe.

Why can’t I sleep on my back?

Sleeping on your back poses problems if you snore or suffer from sleep apnea. In this position, it’s easier for the tissue in your airways to collapse and make it hard to breathe. You also shouldn’t sleep on your back if you’re pregnant. Instead, pregnant women should sleep on their left side.

Is it better to sleep on your back without a pillow?

Back sleepers need a pillow to prevent their neck from dipping down uncomfortably. A pillow maintains neutral spinal alignment and eases discomfort. We recommend shredded memory foam pillows so they can be molded to fit a variety of sleep needs.

Does sleeping on your back make you taller?

Not necessarily. Healthy growth and development depends upon getting enough rest. Sleeping in a neutral position—whether it be on your back or side—allows your body to achieve better sleep, and as a result, grow stronger and healthier.

Why is stomach sleeping unhealthy?

When you sleep on your stomach, your belly sinks into the mattress and creates an uncomfortable arch in your lower back, and you have to twist your neck to the side to breathe. “This arch in your lumbar spine is called Lordosis and it is the natural curve in your spine, but it can become more curved – called hyperlordosis – which may contribute to lower back pain,” says Dr. Sheth. Sleeping with an arched back and twisted neck is unhealthy for your spine and may contribute to chronic pain.

Back Sleeping for a Good Night’s Sleep

Back sleeping is the healthiest for your spinal health and is the most recommended sleeping position for those with back pain. While training yourself to sleep on your back can be challenging, the benefits are well worth the effort. If you’re having trouble sleeping in the supine position all night, try using pillows to prop and prevent yourself from rolling onto your side or stomach.  With the proper effort, you can be a back sleeper in no time.