Back, Side or Stomach: Which Sleep Position Is Best for You?

How to make sure your spine's in alignment when you sleep
man sleeping on his stomach

Just as a factory worker risks injury by working in the same position all day in a factory, you risk injury by sleeping in the same position all night.

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For instance, sleeping exclusively on your right side can cause pain in your right shoulder. And always sleeping on your stomach can trigger back and neck pain.

“Your body likes variety,” says chiropractor Andrew Bang, DC. “For example, if you doze off while you’re on your back, you should switch from one side to the other during the night.”

Alternating between your back and sides is usually more comfortable and less stressful to the spine than sleeping on your stomach. 

Sleeping on your stomach

Sleeping on your stomach will keep your head turned in one direction or the other for a period of time, which causes pain. 

“Imagine standing and looking one way for two or three hours at a time. Stretching your neck muscle for that long creates soreness,” says Dr. Bang. 

Sleeping on your stomach also extends your neck backward, compressing your spine. Then you get tingling in your arm, or your arm may fall asleep, as blood flow is constricted and nerves are compressed. 

“Avoid bringing one leg up,” he cautions. “It can lead to soreness by torquing your hips and low back.” 

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If it’s hard to break your stomach-sleeping habit, try sleeping on your side with a body or side pillow. This may provide the same reassuring pressure on your chest.

But is sleeping on your stomach is bad? 

Major medical journals agree that side and back sleeping is associated with less spinal pain. The American Academy of Pediatrics recommends infants sleep on their backs to avoid their vulnerability to sudden infant death syndrome and that it causes a higher heart rate than if they sleep on their backs.  

Sleeping on your back

Back sleeping is easy on the spine because gravity keeps your body centered over it. With the right neck support from a memory foam or latex pillow, your neck should maintain its normal banana-like curve. 

“This can help some — though not all — back sleepers with sleep apnea,” says Dr. Bang. 

If back pain makes sleeping on your back a challenge, he suggests placing a pillow under your knees. 

Used to watching TV on your back as you fall asleep? This creates poor neck posture, warns Dr. Bang, and will result in neck pain after a while.

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Sleeping on your side

If you sleep on your side, you’ll want to keep your head in neutral posture, with your chin straight ahead. 

Tucking your chin down when sleeping in a fetal position on your side produces a painful forward head position, cautions Dr. Bang. 

“When you’re standing with ideal posture looking at the horizon, your ear hole should line up with your shoulders,” he says. “Try to keep that posture when you sleep.”

Checking your alignment

The bottom line: “It’s all about body mechanics,” says Dr. Bang. You have to keep your spine in alignment, just like your car. If you hit a bump with your car, you can still drive. But you feel a shudder, and you know it’s not good for your car.”

In the same way, bad postural habits when you sleep aren’t good for your body. They’ll throw your spine’s alignment off and give you problems down the road.

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