Sleep Positions: Back, Stomach or Side, What is the Best Position for You?

Sleep Positions - Back, Stomach or Side, What is the Best Position for You? by Elmira Family Chiropractic

When your Chiropractor asks you what position you sleep in, what do you say?

Do you sleep on your back, stomach or side?

Sleep positions are important as we spend about 1/3 of our life sleeping! There is a lot of misinformation and I am going to cover the sleep position topic and the best way to get a good night sleep.

First, lets talk about the three main positions.

1) Sleeping on your back– and what I would deem the worst position…

First, sleeping on your back causes hypoxia (low oxygen).

Do you have a snorer in your life? What position are they in when they are snoring…?

Their back.

Why is that?

When you lay on your back you become a mouth breather and your airway is smaller. This can lead to decreased oxygenation of the brain and body(up to 30% less!). Less oxygen also means more work for your heart. This can lead to increased blood pressure and heart rate, causing your heart to work harder to move the necessary oxygen to the entire body.

Sleeping on your back with a pillow of any kind, brings your head forward overnight. This is the same position your head tends to stay in all day when you are hunched over your work.

This is a problem because of the phenomenon called creep. Creep is the consistent deformation of ligaments and muscles when placed in a static, non-moving position. This means that your muscles, bones and ligaments will start to assume your bad posture/position even when you’re not in that position. Lying on your back with a pillow is reinforcing that forward head posture and creep.

Forward head posture causes the normal lordosis (curve) in your neck to flatten and start to reverse over time. Adding extra forces to the bones and discs can lead them to degenerate, cause bone spurs to develop and a loss in range of motion.

It has been found that with back sleepers, especially back sleepers with flat degenerating cervical spines (necks), that the accessory muscles of respiration (scalenes, SCM and upper trapezium) have to work hard to compensate since the diaphragm will not be able to work fully because we can not get full expansion of the rib cage on our back.

So get off your back!

2) Sleeping on your stomach

Most of you will not believe what I’m going to say, but I sleep on my stomach for a good portion of the night…GASP!

Let me rewind a little bit.

How important is tummy time for an infant or developing child for motor and structural development?


When an infant is first learning how to move they must start on their stomach and then they begin panning, which means they are lifting their head AND looking side to side. This movement is purposeful as it is the beginning of how a child develops the lordosis (curve) in their neck. This is also how the joints of the spine grow to have the angles and articulations that we need.Panning

Through tummy time, babies develop the muscles required to extend and rotate their head on their neck.

So, do you think it is possible that this could also be important for adults?

Stomach sleeping, without a pillow is like tummy time!

This position can act in opposition to all the hours we spend looking down at our work (or children – hello mommas!).

The other great thing about stomach sleeping is your airway will be OPEN in extension, you can breath through your nose increasing oxygen to your brain AND your diaphragm will get stronger through exertional breathing.

Now if you are someone who has NO cervical curve (as deemed by x-ray) this position may not be your friend… In that case I would recommend you start on your tummy in this position for a couple of minutes a day before you move to your side for most of the night.

3) Sleeping on your side

I would start here if you’re pregnant and if you have no cervical curve (this is where you will spend most of your time).

Side sleeping had been deemed a great position for a long time but we need to be honest about it. When lying on your side it is likely that you will have:

  • Your head flexed forward
  • A pillow possibly putting pressure on the side of your head and jaw
  • Rotation of the shoulder, spine and/or hip
  • And hips that aren’t really in the same line as the spine (flexion of the entire spine).

When looking for a pillow in this position, please use something thinner and ensure your neck is straight with your spine and your head is not forward.  Also it is highly recommended to put a thin pillow between your knees because without one the spine and hips rotate into a torqued position (not good!).

So how do I integrate this into my life?

Well of course, you are NOT going to stay in one position all night but it’s time we ditch the guilt over waking up on your tummy. I promise I will never be mad to hear that!

No matter what, integrate more time on your tummy, make sure you are getting your spine checked by an awesome chiropractor and get rid of your fancy pillows for lying on your back! Choose a pillow that is comfortable and if you are on your stomach you don’t need a pillow at all.

Dr. Sarah Green

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