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Oh to be able to sleep anywhere and on anything. I remember the days I could be the above racoon and sleep on a log, or just throw a sleeping bag down on the ground and I was good to go. Those were the days. Unfortunately, those days can catch up to us and our sleeping posture can get us into trouble. It is better to start early in life, but now is the second best time to change things for the better. Does the position we sleep in matter with regard to our spine and our overall health? The answer is absolutely YES! Why wouldn’t it? We spend one-third of our lives in bed sleeping, so the position we sleep in should be a big deal for us.
Ideal Sleeping Positions
I have patients ask all the time, “so what is the best sleeping position?”. An easier question to answer is, “what is the worst position to sleep in?”. Unfortunately, the “best sleeping position” comes down to what we can do to make it that way. There are patients that can only sleep on their side, and then there are those that can only sleep on their back. Then comes the stomach sleepers. I’m sure you can guess that stomach sleeping is the worst position. We will talk more about that in a moment, but let’s concentrate on the side and back sleepers first.
- Back sleepers:
- There are two locations you should be concerned about when back sleeping, the neck (cervical spine) and the low back (lumbar spine). The cervical spine and lumbar spine go hand-in-hand, which is why I will not just concentrate on one location only at my clinic. How are they connected you ask? Great question, but that will be in another post. While sleeping on your back, you want to make sure your neck is properly supported. There are plenty of cervical pillows on the market. One of the main ones you will see chiropractors sell or recommend look like this one. Whatever pillow you go with make sure it has a divot, or sunken area in the middle for your head to sink down into and the rest of the support is located under the neck creating the natural curve. I know pillows can be pricey and you don’t know what the best fit is until you start trying them out. I have had patients not use a pillow, to allow the back of the head to be in line with the spine, but then use a rolled up hand towel to place under their neck. A cervical bolster could also be used under the neck to keep the curve. Something like this (below) to keep the curve in the neck, but allow the back of the head to fall back in line with the spine.
- Properly supporting the lumbar spine (low back) is the next item to look at with back sleepers. It is important to place a pillow under your knees to take pressure off the back. As you lay flat with your legs out in front of you, your lumbar spine curve gets accentuated. By placing a pillow (usually the thickness of two fist widths is enough) under your knees, the lumbar spine flattens out more, therefore taking pressure off of it.
2. Side sleepers:
- In the case of the side sleepers out there (I am one of those), the support we are mostly looking for is for the neck and the hips, the sacroiliac joint to be precise. Make sure the pillow that supports your neck is enough, but not too much, to allow the neck to be inline with the spine (in a neutral position). The support of the knees is required, as well. Place a pillow between your knees, about the thickness of one fist width. As you lay on your side, the knees are touching, which actually opens up the SI (sacroiliac) joint and stains it and the ligaments. Hence, placing a pillow between your knees will elevate the top leg enough to keep the SI joint in a neutral position. The other area you can help out are the low back and the hips, the actual ball-and-socket joint this time. If you are feeling pains on the side of your thigh, right on the ball-and-socket, or pain right behind it, going into the rear end, then one possible cause of this might be your bed. Your bed may be broken down enough that your hips are sinking down into it creating a “V” shape in your body pivoting at the hip joint. This can put stress on both sides of the hip, one stretching and one compressing or pinching. Now beds are another post, because of their prices and all sorts of textures and firmness. But, if you are on a budget, one trick to try before spending the money on a bed is to place a small pillow under your hip bone that your are laying on. You may have to play with the thickness of the pillow, but the goal is to find the correct thickness that will keep the hips parallel with the spine and prevent the “V” shape.
- Another thing that can happen with side sleepers is shoulders rolling forward. Think about it. If we are on our side, it compresses and rolls the shoulder we are laying on forward all night. The nerves coming out of our neck travel down the front of the chest/arm and end up getting trapped from being compressed. The upper arm is usually curled up next to us or under our pillow, either case it is rolling the upper arm forward. This starts causing a problem called upper cross syndrome, which is another topic for another day. It is harder to help the shoulder we are laying on, but one thing you can do is put a pillow behind you, so you are more at an angle an off the lower shoulder more. Sometimes this is enough to keep the upper arm back and from rolling forward. If not, then you can prop a pillow under the upper arm to support it from rolling forward. Several of my patients like using a full body pillow, as you can use it to place between your legs, as well as, prop your upper arm up.
The Worst Sleeping Position
As I mentioned before, you probably already knew that the stomach is the worst position to sleep in. I have plenty of patients say the the stomach is the only way they can sleep. Don’t be worried if you are one of them. It may take some work, but you can become a back or side sleeper, and will want to become a back or side sleeper (I hope). There are a couple of reasons you will want to stop the stomach sleeping.
- Your cervical spine is severely stressed when you are on the stomach. The only way to breathe is to rotate the neck to one side. A massive stressor on the neck. You spend 6-8 hours in a position where the natural cervical spine curve is not supported. The torque placed on the cervical spine is tremendous with some structures (nerves, blood vessels, ligaments, muscles, tendons, bones, cartilage) getting stretched and the other side structures getting compressed. The other aspect to this is the temperature difference from the side that is against the pillow and the side that is exposed to the air or fan. One side of the neck can be hot and the other side cold, which causes muscles to constrict. All of this stresses the nervous system, which is protected by the spine and is responsible for every function in your body. Definitely a major thing.
- The second reason stomach sleeping is the worst sleeping position is because it puts the lumbar spine into hyperextension all night long. This means that the natural low back curve is being forced farther back for extended periods of time. This will create subluxations, which are joint restrictions or misalignments of the vertebrae that irritate the nerves, therefore not allowing the body to get what it needs and to function correctly. The other thing it causes is inflammation in the joints of the low back. As the low back goes into hyperextension, the joints hit each other creating inflammation and pain.
So What Now? How Do I Change It?
So, you are a stomach sleeper. Now what? One thing you can do is ask your wife or husband to tap you and get you to roll over if they wake up and find you on your stomach. Or you can try to fall asleep on your back with a pillow on your chest. Sometimes the small amount of weight helps keep you from rolling over. You can also try putting a pillow under one shoulder, so you are slightly elevated at an angle. Then when you get comfortable with that, add another pillow. Do this until you are sleeping on your side. Finally, a method I have shared with patients for kind of a last resort type of thing is to put a tennis ball on your stomach and wrap an ace bandage around yourself to hold the tennis ball in place. Another way of doing the tennis ball would be to sew a sock into the front of a t-shirt, creating a pocket to place the tennis ball into. Don’t laugh. This actually has helped people. You will definitely wake up if you roll over onto that tennis ball that is pressing into your gut!
There it is people. The good, the bad, and the ugly with sleeping positions and how to make changes. Have a great day and don’t forget to see your chiropractor to keep your spine healthy and your nerves working the best they can.
The information, including but not limited to, text, graphics, images, and other material contained within this article are for informational purposes only. The purpose of this article is to promote broad consumer understanding and knowledge of various health topics. It is not intended to provide or be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your chiropractor, physician, or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read within this article.
