Side Sleeper: What You Need to Know About Sleeping on your Side

If you look at nearly any poll about people’s favorite sleeping position, side sleeping will almost always emerge as the clear winner. The exact percentage varies, but it’s easily the most popular of the three sleeping positions. The other two positions are back and stomach sleeping, and they tend to lag behind in polls by a significant amount.

Yet there’s a lot people don’t know about side sleeping. They may not understand all the benefits or they may not know there’s a right and wrong way to sleep on their sides. It’s not as if people are born with a “User’s Guide to Side Sleeping,” after all.

So that’s what we set out to write—a guide that covers what you need to know about sleeping on your side. Our article includes the pros and cons of the position, along with the tools you need to sleep on your side soundly.

The Pros of Side Sleeping

Side sleeping can often promote greater physical health. The position can ease symptoms of sleep apnea and acid reflux. “Plus, side sleeping is the most comfortable and safe position to sleep during pregnancy,” says Dr. Bhavik Sheth, Physical Therapist.

Reduces Snoring and Sleep Apnea

What’s one big advantage side sleeping has over back sleeping? Back sleeping can worsen snoring and obstructive sleep apnea. Your jaw, tongue, and other soft tissues collapse in your throat when you lie on your back. The collapsed soft tissue narrows your airway and makes breathing more difficult.

Why is it important to manage sleep apnea? Because untreated sleep apnea is linked to:

• High blood pressure
• Heart disease
• Weight gain
• Type 2 diabetes
• Asthma
• Acid reflux

While stomach sleeping can reduce snoring and sleep apnea, the position can obstruct a person’s breathing in other ways. Stomach sleepers have to twist their necks to the side to breathe, misaligning their cervical spine. If stomach sleepers don’t keep their heads at this awkward angle, then they’re breathing straight into their pillow and mattress.

“Stomach sleeping also affects lower back posture and can increase lumbar lordosis – an overarching of the spine. Increased lumbar lordosis is associated with acute and chronic low back pain and is often improved by lifestyle modifications including sleeping position,” says Dr. Bhavik Sheth.

We would also argue that managing snoring and sleep apnea symptoms isn’t worth the risk of developing chronic back pain from sleeping on your stomach regularly.

Side sleeping is easily the best position when it comes to controlling snoring and sleep apnea.

Aids Digestion

Sleeping on your side prevents stomach acid from rising and holds stomach contents in place better than back or stomach sleeping. When you lie flat on your front or back, your stomach’s acid can flow up your esophagus, causing damage and conditions such as Barrett’s esophagus. However, lying on your side ensures gravity will keep your stomach acid from flowing upward.

Digestive issues side sleeping can prevent or manage include heartburn, acid reflux, and GERD.

Clears Out Brain Toxins

Our bodies have a waste system known as the glymphatic system. It clears out waste in the brain and may also help deliver compounds such as glucose, lipids, amino acids, and neurotransmitters.

Never heard of the glymphatic system? That’s likely because researchers only discovered it within the last few years, so there’s still a lot to learn.

One thing scientists have discovered about the glymphatic system? Your sleep position can influence its effectiveness. The system operates more efficiently when you lie on your side than on your back or front. A 2015 study speculated that may be part of the reason side sleeping is the most popular position.

Why is it important for the glymphatic system to operate at peak efficiency? Scientists suggest that its waste disposal function may play a key role in preventing neurodegenerative diseases. For example, Alzheimer’s disease is linked to proteins piling up in the brain.

The Cons of Side Sleeping

Of course, a list of pros also comes with a list of cons. There are a few drawbacks to consider when it comes to side sleeping.

Increased Pressure on the Heart

This con applies to left side sleeping only. When you lie on your left side, your position causes your chest cavity to press against your heart. The added pressure on your heart can affect your cardiac output and your heart rate. While an average sleeper may not notice this increased pressure, a 2003 study found that patients with congestive heart failure avoided sleeping on their left side.

Potential to Develop Bad Posture

When you lie on your side, it can be all too easy to have bad posture without realizing it. You can twist your body too far and shift your spine from its neutral alignment.

As you lie down to sleep, double-check your body’s posture. Your head should be between your shoulders, and overall your body should feel relaxed and untwisted. Make sure your chin isn’t tucked against your chest because this can cause neck pain.

If you have problems maintaining your posture as you sleep, try using extra pillows as sleep aids. Knee pillows and body pillows can help you keep your body in place.

SEE ALSO: How to Sleep with a Body Pillow at Night

Increased Risk of Shoulder Pain

Side sleepers are more likely to wake up with shoulder pain than stomach or back sleepers; the shoulder they’re lying on can push too far into the mattress, causing spinal misalignment.

If you tend to experience shoulder pain, you might try slipping a thin pillow under your shoulder. You can also try sleeping on the opposite side to reduce shoulder pain from acute conditions such as Shoulder Impingement. Make sure this shoulder pillow doesn’t raise your body too high, or your head pillow might not be thick enough to support you.

Increased Risk of Acne

An adult side sleeper presses half their face into their pillow for about 7 to 9 hours a night. Since pillows collect our facial oils, sweat, and other nasty debris and irritants, side sleepers may experience increased acne on one side of their face. Sleepers can prevent adult acne by changing their pillowcases at least once a week and by taking care of their skin when they’re awake.

Awkward Position for Arms

When you’re trying to fall asleep, you don’t want your arms to also “fall asleep” and grow numb. However, this is an issue side sleepers often face. Many side sleepers tuck their arms under their pillows, developing pain and numbness in the arm and shoulder areas.

Instead of doing this, try stretching out your arms. If your mattress size is too small to do so, you can keep your arms comfortably in place by hugging a pillow.

Side sleepers might also wish to examine the pillow they’re sleeping with. If their pillow feels unsupportive, they may subconsciously bolster it with their arms.

What Does a Side Sleeper Need?

Side sleepers need the right tools for a good night’s sleep. The best mattresses for side sleeping offer a conforming cushion that cradles the shoulders and hips yet provides the support needed for optimal spinal alignment. Side sleepers also need the right pillows to contour to the head and support their neck.

Of course, not everything beneficial for a side sleeper has to be bought. Many side sleepers can establish a morning stretch routine that will leave them limber and ready to face a new day.

Choosing the Best Mattress

There’s no one perfect mattress for side sleeping. Some side sleepers want a soft mattress to sink into, while others prefer a spring bed with a medium feel.

Side sleepers who like a bed that cushions and cradles them may consider a memory foam mattress. Memory foam is one of the best materials for pressure relief, yielding to the body while supporting its curves. A memory foam mattress for side sleeping can provide mornings free of aches and pains.

Memory foam mattresses are also some of the most affordable beds on the market. Many excellent memory foam mattresses cost under $1000. Even the more luxurious memory foam mattresses tend to have reasonable prices in the $1,000 to $2,000 range.

Latex mattresses are a good choice for side sleepers who like memory foam but are interested in a more sustainable bed. Natural latex mattresses usually contain other materials like organic cotton, wool, and upcycled coils.

Latex can also feel cooler and firmer than memory foam, perfect for side sleepers who want to avoid sweats and sinkage. However, a quality organic latex mattress can cost a lot more than a memory foam mattress. The average price of a queen size latex bed is $2100, according to Sleep Like the Dead.

Meanwhile, side sleepers who like a bouncy bed that keeps them on top of the mattress rather than in it should consider a hybrid mattress. A hybrid mattress for a side sleeper should possess a foam top at least 2 to 3 inches thick. This design offers the pressure-relieving cushion that a traditional innerspring mattress can’t provide.

Once you’ve decided on the perfect mattress type, it’s time to consider your mattress firmness. Side sleepers need a soft to medium firmness when looking at mattresses for pressure point relief.

The lighter you weigh, the softer the mattress you may need. Otherwise, you might wake up stiff and sore because your body can’t press down enough to make the mattress conform and cushion your body. Petite side sleepers under 130 should consider a medium-soft or soft mattress.

Conversely, heavyset side sleepers might want to consider a mattress with a touch of firmness to avoid waking up with back pain. A medium or even a medium-firm bed can buoy a side sleeper, preventing their hips and shoulders from sinking too deeply and misaligning their spine.

A mattress for a heavy person can have a soft feel, but it’s important to double-check how it balances its plushness with supportive features. Good features to look for include a transition layer for limited sinkage and targeted back support.

If you’re a hot side sleeper in need of a cooling mattress, there are a few features you can keep an eye out for:

• Gel infusions that pull heat away from the sleeper. Potential infusion materials include copper, charcoal, green tea extract, ceramic beads, and titanium.
• Cutouts and ventilation holes in the mattress to increase airflow through the bed.
• Breathable mattress cover fabrics. They might be as simple as a cotton cover, or a more high-tech phase-change fabric.
• Coil support system instead of thick base foam. Coils have more open space to promote airflow than a dense foam base.

As side sleeping is recommended during the later months of pregnancy, sleepers can benefit from a mattress for pregnancy that focuses on pressure relief and support for their expanding bodies.

Choosing the Best Pillows

The right mattress is only half of the secret to a good night’s sleep. A side sleeper should also have an excellent pillow to ensure no part of their head and neck goes unsupported. We strongly recommend side sleepers always sleep with a head pillow since the span of their shoulders creates a large gap between their head and the mattress.

The best pillows for side sleepers have a high loft between 4 to 6 inches. If the pillow is too low or too high, your neck muscles may strain themselves trying to support your head.

The pillow should also feel firm to maximize neck and head support. However, side sleepers who switch sleep positions may want to look for a pillow with a flexible filling to adapt to movements. Shredded memory foam or down-filled pillows can be fluffed up and flattened down.

A good side sleeping pillow also contains breathable, cooling materials, such as gel fibers or shredded foam.

Some side sleepers may prefer slipping a contour pillow under their heads instead of lying on the standard rectangular pillow. A contour pillow possesses a curved design that creates a hollow for the head with raised sides for the neck. You may also see them called cervical pillows.

Side sleepers may also benefit from using a supplemental knee or body pillow. A side sleeper’s legs may draw their hips out of alignment during the night, but slipping a pillow between the knees keeps their upper leg aligned with their hips and spine.

As we mentioned earlier, a side sleeper’s pillows and pillowcases can collect bacteria that interferes with their skin and sleep. Side sleepers may want to look for easily washed materials, such as pillows with shredded foam or down-like fills.

Stretches in the Morning

Side sleepers may experience a slight morning stiffness from subconsciously curling up as they slept. Stretching after waking up invigorates circulation and loosens up muscles and joints.

For example, if your neck feels stiff when you wake up, you can loosen up with a neck stretch, one of our top recommended stretches for improved flexibility. Side sleepers often benefit from simple stretches that exercise the arms, back, neck, shoulders, and hips. “Some of my favorite stretches for the spine, hips, and knees are most comfortable in a side sleeping position,” says Dr. Bhavik Sheth, Physical Therapist.

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Frequently Asked Questions

Which side of the body should a person sleep on?

We always advocate sleeping on the right side for a healthier heart. Sleeping on the left side places pressure on the heart, while the right side adds no such pressure. Lying on the right side also decreases sympathetic nervous system activity. This is the system that governs a person’s flight-or-fight response.

The exception to the rule is pregnant women, who can increase the nutrients and blood flow to their babies by sleeping on their left side.

Why does sleeping on my side hurt?

Most likely, sleeping on your side hurts because you have a too-firm mattress that doesn’t conform to your shoulders and hips. If a pressure-relieving mattress doesn’t cradle your shoulders and hips, then they may feel sore and stiff the next day. Remember, the best mattresses for side sleeping should have a soft to medium feel with a top layer of malleable foam.

What is the healthiest sleep position?

Many experts would say side sleeping is the best position. Lying on your side promotes an unobstructed airway and minimizes the symptoms of sleep apnea and acid reflux. Side sleeping is also linked to more efficient disposal of brain waste.

Back sleeping isn’t without its advantages, however. When you lie on your back, your body weight is evenly distributed, and there’s minimal strain on your spine. If you’re experiencing back pain, a switch to back sleeping can help.

While back and side sleeping both have their strong points, the same cannot be said of stomach sleeping. Stomach sleepers’ hips and abdomens often bow too far into the mattress and upset the spine’s natural curves. Many stomach sleepers eventually develop chronic back pain, which can be exacerbated by a soft or sagging mattress. For stomach sleepers, an extra firm mattress is often recommended to provide the necessary support and prevent the hips and abdomen from sinking too deeply into the bed.

Do side sleepers need a soft or firm mattress?

A side sleeper is usually better off with a soft mattress than with a firm bed. Beds with a soft to medium feel conform more and are better at easing pressure in the shoulders and hips.

The firmest mattress we would recommend for side sleeping is a medium-firm mattress, with the caveat that we mostly suggest it for heavyset side sleepers. Plus-size sleepers often benefit from the supportive feel of a firmer mattress.

Is a pillow top mattress good for side sleepers?

A pillow top mattress is often better than buying a regular innerspring mattress for side sleeping. However, pillow tops aren’t renowned for their durability. They often lose their shape within a few short years.

Are you a side sleeper interested in a bouncy mattress that cushions the body? Consider a hybrid, instead. The dense foam top of a quality hybrid resists compression and maintains its shape after years of use.

What happens to your face when you sleep on your side?

While side sleeping has many benefits, it’s not the kindest position for your face. Sleeping on your side can increase your chances of developing wrinkles. You may also experience more acne breakouts, particularly if you don’t change your pillowcase every few days. However, we argue the benefits of side sleeping outweigh the risks to your face.

Having a good skin care routine can protect your face during the day and while you sleep, minimizing your chances of acne and premature wrinkles. Helpful products to consider include:

• Anti-aging creams to prevent wrinkles.
• Natural face moisturizers for radiant skin.
• Sunscreens for your face to limit the damage caused by UV rays.
• Acne treatments to cleanse your face of bumps and spots.

Side Sleeping with Success

Side sleeping’ can ease symptoms of acid reflux and sleep apnea. The position is also linked to improving the brain’s overall health.

There are potential drawbacks, such as holding an uncomfortable position while you sleep. However, the right mattress and pillows can maintain a healthy side sleeping posture.