Should you change your sleep position?
The internet made me think I should ditch stomach sleeping—but it’s not that simple.
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Sleep position is a hot topic in the realm of snoozing. It's easy enough to find information on the best mattress or pillow you can buy, but sorting out your ideal sleep position is another challenge entirely. You may have come across articles claiming one position is superior to another. Perhaps you've even read that the way you’re sleeping could negatively affect your overall health.
There is a shred of truth to some of these arguments. As the sleep writer here at Reviewed, I was surprised to learn that the conversation around sleep position is simultaneously oversimplified and overblown.
What are the main sleep positions?
You may find yourself in numerous sleep positions overnight, but there are three overarching groups: back sleeping, where you face upward; stomach sleeping, wherein you lie belly-down; and side sleeping, where you position yourself over one shoulder and hip.
Most people don’t really have just one sleep position, often falling asleep one way and waking up in a different orientation. As for the most popular sleep position, that’s highly contested. One research study found that subjects spent the majority of the night on one side, rather than their stomachs or backs.
Is one sleep position better than others?
I’ve heard time and time again that stomach sleeping is the worst way to settle into bed, while side sleeping is a step above. In my experience, back sleeping is always dubbed the golden standard.
In this case, it turns out the rumors aren’t necessarily true: Experts generally agree that you don’t need to change your position. One particular motto comes to mind: If it isn’t broken, don’t fix it.
That said, certain positions can be better for some medical conditions such as sleep apnea. The sleep disorder, which causes people to stop breathing for short periods in the night, can be more common in back sleepers according to Jefferson Health, a hospital system in Philadelphia. With expert guidance, like positional therapy, you can change your sleep position to keep your airways open throughout the night. For back sleepers that suffer from sleep apnea, the hospital says it can be helpful to use a foam wedge or shift to sleeping on the side.
There are also recommendations for sleep positions during pregnancy. For example, people may be able to sleep on their stomachs in the early stages. Meanwhile, it isn’t recommended to sleep supine as it can put pressure on the vena cava, which returns blood from the lower body to the heart. It’s often best for pregnant people to sleep on the left side to allow for maximum blood flow to the baby.
Why do people say back sleeping is better?
This notion was a more traditional way of thinking, says Ben Fung, a physical therapist and spokesperson for the American Physical Therapy Association. "The thought was [back sleeping] has the same optimal posture that you would have in standing in lying down,” he says.
Down the line, experts recognized that sleep position is more about what your body is accustomed to, Fung says. He cites an example of traditional sleeping arrangements in Japan where people would customarily sleep on a straw mat on the floor. “If I were to throw them in a luxury hotel bed, I guarantee you: They would have the worst night’s sleep,” he says. “We would probably be like, ‘This is like heaven.’ They would not sleep a wink.”
In other words: As with all things sleep, it comes down to preference. For the healthy, non-pregnant population, what an online article tells you isn’t what’s most important. Ultimately, it’s what feels best for your body.
Should you change your sleep position?
The answer is even simpler than I’d anticipated: No, almost certainly not. For the vast majority of people, you should not change your sleep position if it isn’t bothering you and you’re not having any daytime symptoms.
“The ideal sleeping position is that which is optimal for your anatomy, physiology, and lifestyle,” Fung says. The best part is that your body probably has already given you this information.
“A lot of people feel pressure to adopt what they read, and what they’ve read may not be fully accurate for them,” he says. Lifelong stomach sleepers who encounter advice that raises red flags can go to a physical therapist or another specialist who can assess the situation. But it's probably not worth overly stressing about. "If you've always been a certain type of sleeper, it's probably fine for you to remain that [way]," he says.
That’s not to say you'll never upset the apple cart. At some point, you may wake up in discomfort even though you’re sleeping in the same position that you always have. It could be a small issue such as taking an extra long flight or another small change that your nervous system is letting you know about.
Fung likens these responses to Chandler Bing's infamous 'Ow!' scene, during which the Friends character is barely able to pick up a cup of coffee after starting a new workout routine. It’s the body's way of telling you that something has changed, and maybe it doesn’t like it.
In these cases, you can more often than not revert back to your preferred sleep position, Fung says. When in doubt, it might be helpful to see an expert like an orthopedic physical therapist who can help you play detective.
Most of the time, if you need to change your sleep position due to a recent surgery, another medical condition, or pregnancy, you’ll already be in touch with a healthcare provider that can help you determine what’s best for you and your needs.
How can you make the most of your sleep position?
It’s impossible to make blanket recommendations for sleep positions, but there is general information that may be of use.
Pregnant people who usually sleep on their stomachs may like a body pillow that can provide the sensation of something pressed to the front of their bodies. We love the Queen Rose body pillow, which is shaped almost like a wide bobby pin that allows you to nestle into the middle. Our tester found it comfortable for not just her neck and head, but also her back.
Consider getting a new bed pillow if you’ve owned your current one for more than a few years. Pillows are especially important for side sleepers, as they support the head and neck and can prevent aches in your upper spine. Our favorite is the Coop Home Good Original Pillow. We love it because it’s machine-washable and filled with shredded foam that can be adjusted to your preferences. The brand also sells a softer option, the Eden Pillow.
Creatively use pillows to get better sleep. Stomach sleepers, for example, may benefit from a thin pillow beneath their shins to lessen the load on their lumbar spine and hips. Side sleepers could benefit from draping their uppermost arm and leg over a body pillow. If you sleep on your back, consider tucking a pillow under your knees.
If possible, make sure your mattress works well for the position you sleep in. Generally, you should replace your mattress every decade. If you tend to sleep on your side, a softer option like the Nectar mattress might be more comfortable. In our testing, we found that its surface is forgiving and great for cradling you as you sleep. On the other hand, stomach and back sleepers may prefer something firmer, like the Tuft & Needle Original. We love that it almost feels as though you’re floating above the surface.
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