SLEEP POSITIONS: WHICH IS BEST FOR YOUR HEALTH?

Published by Dr Gigi on May 20, 2019

At bedtime, chances are you are too tired to be mindful of your sleeping position, so you get into your favorite position and off to sleep you go. The point remains that your favorite position may not be best for your health.

Sleeping in the wrong position can affect the quality of your sleep, cause insomnia, neck, back pain and body aches worsen your snoring and sleep apnea.

Some medical conditions can influence the position you may sleep in, for instance, if you have sleep apnea (where your breathing stops or reduces temporarily while asleep) sleeping in the supine position will make it worse.

The right sleep position can give aesthetically pleasing results by preventing ‘sleep’ lines that result in wrinkles and aging (I am sure no one wants that!)

Improper sleep positions may cause you to wake up aching all over. Beyond sleeping in the wrong position, if you often wake up with pains and aches that were not present at the time you went to bed, you may want to ensure your mattress and pillows are comfortable and suitable for you.

Supine Sleepers

In this position, the individual lays flat on their back with legs stretched out in the neutral position. Arms are usually kept at the side.

In people with swollen feet, the feet may be raised with the aid of a pillow to relieve swelling.

Supine-upright position

This is a variant of the supine position. The individual lays on their back in a semi seated upright position with the knees slightly bent aided by a low pillow or legs may be stretched out. This position enhances chest expansion and relaxes the muscles of the abdomen, consequently promoting breathing and oxygenation.

It is usually recommended for individuals in respiratory distress due to heart failure and in people with risk of aspiration.

Pros

1. Support: This position ensures the body is properly supported by the mattress and pillows.
2. Prevents body pains: It ensures the head, neck and spine are in the neutral position so that they are not under pressure, preventing pains and aches upon waking.
3. Provides chronic pain relief: It relieves back, neck, shoulder or sciatica pain in individuals with pre-existing back and shoulder pain.
4. It prevents heartburn: It is beneficial in relieving symptoms of heartburn in people with acid reflux disease. To prevent acid reflux, use a pillow that appropriately elevates your head so that your stomach is positioned below the level of the esophagus, this ensures that stomach acid does not back up into the esophagus.
5. Prevents premature wrinkles: It prevents the formation of premature wrinkles from sleep lines (lines that form as a result of the face squished against the pillow).10
6. Prevents breakouts and acne: Some individuals may be sensitive to the oil and chemicals in hair products on the beddings causing them to breakout. Sleeping in this position keeps the face off the pillows.

Cons

This position is generally good for people with no medical condition that interferes with their breathing. If an individual has airway obstruction or breathes through the mouth this is not a good position for them.

1. Promotes airway collapse and obstruction: This position encourages the temporary collapse of the airway which interrupts breathing. It worsens obstructive sleep apnea (OSA: a condition where an individual stops breathing temporarily while asleep) a condition common in obese and overweight individuals. 4
2. It worsens snoring: Sleeping on one’s back, especially in obese individuals may cause the base of the tongue to fall back into the airway impeding airflow. The snoring noises are produced when air is forced through the narrowed airway.
3. Increased night wakings: It worsens sleep quality in individuals with difficulty falling asleep or it may cause them to wake up multiple times. If you already experience poor sleep, this is not a good position for you. 5

Belly Sleepers

In this position, the individual sleeps on the stomach with the neck and head turned to either the left or right to allow breathing and the legs stretched out.

Pros

• Improves snoring.
• Relieves obstructive sleep apnea: Recommended with caution for people with obstructive sleep apnea. This position keeps the airway open during sleep by countering the effect of gravity in collapsing the airways.
• May help people with pulmonary hypertension.7

Cons

1. Poor spine support: This position flattens the natural curvature of the spine leading to lower back pain.
2. Nerve pain: Belly sleeping can put pressure on the nerves and causing numbness, tingling and pain (sciatica).
3. Increases the risk of premature wrinkles: Because the face is pressed against the pillow, sleep lines may appear increasing the appearance of wrinkles.
4. Promotes breakouts and acne: In this position the face is in contact with the beddings and the oil and chemicals in some hair products smeared on the beddings may induce acne and skin breakouts.
5. Body pains: Head and neck positioning with the head turned to the side can cause neck pain and muscle strain upon waking up.
6. Arm pain and numbness: A number of belly sleepers tuck their hands under the pillow, under their heads or under their bodies. This puts pressure on the hands, causing nerve compression and reduced blood circulation. The individual may wake up with arm pain, pins and needles sensation or numbness.
7. May compromise breathing: Chest expansion that usually aids respiration may be restricted when an individual sleeps on the belly as it presses against the pillow and the mattress.

Side Sleepers

This is considered one of the best sleep positions. Side sleepers lie on either the left or right side with legs stretched out or in the fetal position. When in the fetal position, try not to curl yourself up into a ball. Rather, untuck your chin from the chest and straighten out your knees as further out as you can to prevent aches and pains upon waking up.

To maintain a proper sleeping form, use a pillow that fits perfectly between your head and the mattress so that your head and neck are aligned in the neutral position. You can reduce strain on your hips by placing a pillow between your knees.

Pros

1. Prevents body pain: It prevents neck, shoulder and arm pain that may result from abnormal positioning of the body.
2. Maintains open airway: The airways are kept open in this position particularly beneficial to people with obstructive sleep apnea.
3. Decreasing the chances of snoring. Open airway prevent snoring.
4. Great for pregnant women: The fetal position on the left side is the preferred position for pregnant women. It improves blood circulation to the mother and baby.
5. Relieves heartburn: Sleeping on the left side relieves heartburn. It prevents the transient relaxation of the lower esophagus. Sleeping on the right worsens the symptoms of heartburn.9

Cons

1. Right side sleeping worsens acid reflux disease: Sleeping on the right can worsen symptoms of heartburn especially in people with gastroesophageal reflux disease (GERD). People with GERD have relaxed lower esophageal sphincter (structure separating the stomach and the esophagus) and sleeping on the right enhances this relaxation and worsens their heartburn.10,9
2. Pains with prolonged side sleeping: Prolonged pressure on the shoulder and arm when sleeping on one side for a long time may cause that side to become numb, painful, blood flow to the arm may be restricted and you may wake up with painful ‘pins and needles’. If the arm is positioned wrongly the arm may become painful.11
3. Promotes breakouts and acne: The face is usually in contact with the beddings and oil and chemicals in some hair products smeared on the beddings may induce acne and skin breakouts.

In Summary

Beyond sleeping in the wrong position causing poor sleep, several other factors may also be responsible including the type and quality of mattress and pillows you sleep on.

Secondly, poor sleep quality may be due to an untreated sleep disorder, coexisting medical conditions, obesity and so on.

A useful rule of thumb is to sleep in the position that you are comfortable in, taking your health status into consideration (e.g heartburn =left side position or supine) and above all, do not sleep for extended periods of time in