We get this question a lot!
For decades, chiropractors have been saying that sleeping on your back is the best position, with side sleeping the second best option if you absolutely can’t sleep on your back.
There are orthopedic pillows that support the neck while sleeping on your back, and there are those who recommend sleeping with a pillow under your knees to take the strain off your low back, and to keep you on your back throughout the night.
It makes sense, right? If you think about the alignment of the spine, sleeping on your back seems to be the most intuitive way to sleep, with a good pillow that supports the curvature of the neck.
…But recently we’re starting to think differently.
Studies have shown that we actually breathe better when we are lying face-down. During the height of the COVID pandemic, ICU specialists found that those with severe respiratory distress could breathe better if they were lying face-down (or what we call “prone”).
When we are face-up (supine), all the stuff that drains from your nose goes down your airway. Here in the Brazos Valley, we have lots of allergens and lots of sinus infections due to our high humidity. Americans are showing huge increases in the number of sleep apnea diagnoses… perhaps because of the physical blockage of the airway due to supine sleeping.
Also, lying on your stomach forces us to turn the head to one side or the other, which has been shown to create a better neck curvature than using the special pillows. I recommend alternating – sleep with your head turned to the right one night, and then the left the next night.
When SIDS became a big issue in the 1980’s and 1990’s, pediatricians recommended that all babies needed to sleep on their back. But as soon as they are able to roll from front to back and back to front, let them sleep on their stomach. They should hit that milestone by 6 months of age.
When you sleep on your stomach, don’t use a pillow and don’t put your arms up under your head. Sleep with your arms by your sides and legs straight.
If you have been sleeping on your back for all of your life, it can take some time to get used to a new sleeping position. Start in the position you want to transition to, and you will likely turn to a different position pretty quickly. Over time, your body will learn and adapt.
If you absolutely can’t sleep on your stomach, find a position that is comfortable. If it hurts, don’t force yourself to keep doing something that hurts. If you like sleeping on your side but it is becoming uncomfortable, try putting a pillow between your knees to stack the hips on top of each other.
One last note: if you are suffering from a severe pain condition right now – such as a disc herniation – find whatever position is most comfortable. Don’t worry about “best” for your spine, just whatever position is comfortable. We will start working towards changing positions once the inflammation from the disc herniation is calmed down, but in the beginning, just try to find any position that is comfortable.