Your Guide To Perfect Sleeping Posture

Dr Xandra Posture, You

Is Sleeping Posture Important?

All posture is important, just like day time posture can affect your health, so can sleep posture. Poor sleeping posture can cause back and neck pain, headaches, tiredness, reduced circulation, cramp, reflux and digestive upset (1).

The reason you can have problems at night is down to strength in your core muscles. While you are awake two types of muscles are supporting you. The first are your conscious muscles, the ones that if asked to tense them you could. For example if you think about tensing the front of your upper thigh, you can. However the second set are your unconscious core muscles. These are controlled by your brain and nervous system but have no conscious link. This means that by thinking about it you cannot tense them.

It is the second set that support your spine whilst you sleep, however if they get too weak due to sitting too much, injury, surgery or simply not doing enough exercise, then when you sleep they are not strong enough to help you. You then use the bigger conscious muscles to turn and support you at night. These muscles are bigger, stronger and put more strain on the joints.

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Should I Lie On My Back To Sleep?

Sleeping on your back has always been seen as the golden standard for keeping your spine in line. However, it can cause tension in your lower back due to the normal curve there. Women tend to notice discomfort more than men as their lower back curve is bigger. It has also been seen that lying on your back can cause an increase in snoring. If you feel this is how you want to sleep then putting a pillow under your knees to relax the lower back curve is best.

Is Lying On My Front Bad?

Lying on your front can help to ease snoring but other than that it is bad for your health. It straightens the normal lower back curve creating pressure that could lead to pain. You also have to be able to breath so you must turn your neck a long way to one side. With the added weight on your neck in this position you will end up stressing those joints and it could lead to neck pain or headaches.

Breathing is harder on your front and this can mean a lighter sleep pattern so more tiredness during the day. At the very least a pillow under your lower abdomen could help pressure on the spine but really you should train yourself out of it. One of the ways I suggest to my patients is to use a body pillow so when you try to roll to your front it stops you and keeps you on your side.

What Pillow Should I Use?

Whilst it may feel comfortable, a soft pillow gives you no support for your neck. If you have ever found yourself shaping or pummelling the pillow under yourself, it is because your neck needs it.

Your neck should be curved, yet daily life, technology, etc. can reduce this curve, so it’s important at night that you rest with a curved, supportive pillow. This allows you to relax the muscles around your neck and helps that curve in your sleep.

You position one joint in alignment with the next so your neck is properly supported. This helps to put your shoulders in the right place, aligns your lower back and puts your hips in a good place.

Over time with my patients I have seen issues with memory foam pillows due to the hard density and the heat that they can generate. I suggest a regular foam shaped pillow in my clinic and I also use one with a curve at the front and then a dip for the head to sink into.

Which Sleeping Position Is Best For Your Back?

If you are a back sleeper and it is comfortable, that is fine, however a pillow under your legs to relax the lower back curve can really help. Side sleeping is generally the most common position and the one I recommend, so long as you are on a supportive mattress. This then puts the least amount of strain on the spine whilst allowing the natural curves of the body to sink into the mattress. As importantly, it is also comfortable.

Whatever position you choose to fall asleep in, it is likely your body will move you in your sleep, so your core strength is important in helping your position while asleep.

Which Side Should I Sleep On?

Due to anatomy your left side is better for sleeping on as this aids your circulation (2) but I would say this is minor and once you fall asleep you’re likely to move. Trying to lie on the left side to fall asleep though is a good idea but I would suggest there are more important factors like pillow and mattress. Your mattress and pillow play a huge part in how your body shifts when you sleep, and how much strain you place on your body and therefore your health.

What Sort Of Mattress Is Best?

I get asked this question a lot in practice and I believe that a mattress alone is simply not good enough. I always help my patients select the right firmness of mattress and then stipulate that the correct mattress topper is the key to a great nights sleep, putting less strain on the joints.

For the mattress itself, there are a few considerations to make. Especially important is your weight and the weight of your partner. If you are very slim built then a medium firm mattress is fine. I wouldn’t recommend going any softer than that as you need support at night and mattress’s tend to get softer with age so you don’t want to start that way. If you are average build or above I would recommend going for a firmer mattress to give you more support.

Going for a mattress that is too hard is uncomfortable to sleep on and can make your joints sore. However it is always possible to make a harder mattress softer and more comfortable. It is not possible to make a very soft mattress support your spine.

Once you have the right mattress density, adding a topper is one way to make sleeping feel luxurious and support your joints at night. A topper is a section of foam that is the same size as the bed and around 3 inches or 7 cms thick. If you are a side sleeper it allows your hips and shoulders to sink in whilst supporting your back.

There are many types of topper and picking which suits you is fine, personally I have always preferred the egg box foam type as I feel it puts less pressure on my hips as I lie on my side. It is also cooler than memory foam. I recommend this type for my patients and also my friends and family.

How Should I Sleep In Pregnancy?

In short, however feels comfortable! I can tell you that there are safe ways to sleep and ones that are better for your spine, however, your body will guide you. Ideally sleeping on your left side is best and sleeping on your back is not recommended.

At first, however you normally sleep is fine. As you get further into pregnancy I recommend a variety of pillows to support you.

The 3 tips I have found are:

  1. A good neck pillow – Odd as this may sound, when you want to make your lower body comfortable, a good neck pillow can help you to relax your shoulders. Even if you have lower back discomfort, I have found with patients that getting good neck and upper body supports seems to help the lower back.
  2. A pillow between your legs – This helps the pelvis to align and can relieve a lot of pressure as you sleep. I have also seen this help patients who are getting sciatica (leg pain) at night.
  3. A full body pillow – This is best in the later stages, though starting early is fine. Put one end between your knees for support then under the bump to take some of the weight, and finally to hug so your arms are supported. The best part of this pillow is that you can use it once the baby is born. Wrap it around you back to support yourself in bed and you still have enough left to support the baby whilst you breast feed.