The Best Sleeping Positions, According To Science

Most of us have a go-to position that we instinctively adopt at night, but it may not be the best one for the quality of your sleep, or more general health.

Poor sleep positioning is linked to health issues including snoring, sleep apnea, neck and lower back pain and acid reflux, among other things.

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Spire Workplace Health Principal Consultant Alex McGeoch said: “The best sleep position is one that supports the body to maintain the natural curves of the spine throughout sleep, without compromising respiration or circulation.

“There may be pros and cons with each sleep position depending on your medical status, life stage and natural preference, so if you’re uncertain it may be worth discussing preferred positioning with your physiotherapist or health professional.”

Alex took us through the benefits and disadvantages of the various sleeping positions – side, front and back – to help guide you to the optimal position to avoid neck and back pain and get a good night’s rest.

Side (log position)

“The sleep position that I would recommend for an individual may vary depending on their medical status or history, though the general principle remains the same for all.

This position, with your torso and legs straight, is the one that I most commonly recommend to my patients, as it is effective at maintaining a neutral spine position throughout the night, thereby assisting in warding off neck and lower back pain.

It is important to note that a quality shoulder-width pillow should be placed under the head and a pillow between the knees in order to optimise spine support. Sleeping on your side is the preferred position for those who snore or have sleep apnea, as it supports an open airway throughout the night.

It is also the preferred position for those who suffer from acid reflux or those currently pregnant – noting that pregnant women should sleep on their left side in order to best support blood flow and nutrients reaching the growing baby.”

Back

“This position delivers a neutrally aligned spine – good alignment of the head, neck and spine – and evenly distributes body weight across its full surface area, minimising pressure areas. Put a small pillow under your knees to provide additional support and help maintain the natural curve of the spine.

If you suffer from lower back pain or sleep apnea, avoid this position as it’s unlikely you’ll experience an effective night’s sleep.”

Side (foetal position)

“Sleeping in a loose foetal position, with your torso hunched and knees bent, is the most popular position – again, great if you’re pregnant or a snorer.

However, curl up too tightly and you can restrict breathing in your diaphragm, leaving you aching in the morning, especially if you suffer from arthritis in your joints or back. To avoid this, keep your body as straight as you can rather than pulling your knees up and tucking your chin in. A pillow between your knees can also reduce hip strain.”

Front

“This is the worst position most people can choose. Sleeping on your stomach puts pressure on muscles and joints, risking aches, numbness and irritated nerves. Although it can offer relief to snorers, more often than not it causes back and neck pain as your spine isn’t in a neutral position.

It’s best to avoid sleeping on your front, but if you must, lying face down rather than with your head turned to one side will keep the upper airways open.”


Whichever sleeping position you choose, it should form part of your considerations when picking out a new mattress and pillows.

“A head pillow should maintain the natural posture of the neck,” Alex added. “For side sleeping, ensure you have a firm shoulder-width pillow under your head so it isn’t tilting down onto the bed, or up due to an excessively large pillow.

“Memory foam is a good option as it is firm but also moulds to the shape of the head and neck. It is also best for side sleepers to have a pillow between their knees, and for back sleepers to have a pillow under their knees to reduce the loading on their back at night.”

Alex recommends his clients change their pillows every 12-18 months and replace their mattress every ten years.

He concluded: “A mattress should be well made, fully supportive, and comfortable. Firm mattresses are most frequently recommended, though there is some evidence to suggest that medium-firm may be better for people with long-term lower back pain.”

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