Why Sleep Position Matters More Than You Think

How do you sleep: on your back? On your side? Maybe on your stomach? Over the years, we all develop a preferred sleeping position, often without giving it much thought. But your habitual sleep posture can have significant effects on your health, from spinal alignment and hormone regulation to digestion and cardiovascular function. Some positions may even support certain conditions, while others can contribute to discomfort or long-term issues.

Sleep is a cornerstone of wellness. We spend roughly a third of our lives asleep, yet studies show that many adults fail to achieve restorative sleep, which can disrupt hormone balance, impair brain function, slow athletic recovery, increase stress, and raise the risk of chronic disease. Beyond practicing good sleep hygiene, like limiting screens, maintaining consistent sleep schedules, and creating a calming environment, the position you choose to sleep in plays a critical role in your overall health.

Sleep Positions 101

Sleeping positions influence the body in unique ways, placing pressure on specific areas and affecting physiological processes. They impact spinal alignment, circulation, respiratory health, digestive efficiency, and even the brain’s glymphatic system, the brain’s natural detoxification pathway. Your sleep position can affect everything from your spinal alignment, circulation, respiratory health, digestive efficiency, and even the brain’s natural detox process. For example:

• Sleeping on your right side puts pressure on the blood vessels that return blood to the heart after being circulated through the body, this puts a crimp in circulation.

• Sleeping on either side can cause tightness in your jaw on the side you’re sleeping on due to pressure exerted while sleeping. This can also cause wrinkles.

• Sleeping on your side can help to prevent sleep apnea and neck and back pain, as it keeps the spine aligned.

• Sleeping in the fetal position has been suggested to help prevent conditions like Alzheimer’s and Parkinson's, as it promotes the clearing of toxins and other waste from your brain.

• Sleeping flat on your back can lead to snoring, which can disrupt sleep and lead to the thickening of the carotid artery.

• Sleeping on your side can also beneficially affect your spinal alignment, depending on how straight you’re sleeping.

• Sleeping on your stomach can lead to lower back and neck pain as you sleep with your head turned to one side all night.

• Sleeping on your side has also been suggested to be beneficial to the glymphatic system, which is the brain’s detoxification system.

These examples all prove that there is no “correct” sleep position that applies to everyone. Rather, you must find a sleep position that will be beneficial to you!

The Best Sleep Positions for Health

If you have digestive problems:

Sleeping on your right side may not be optimal for digestive health. This is because sleeping on the right side forces food to work against gravity, which will hinder digestion. Thus, sleeping on your left side is optimal for digestive health.

However, Dr. Johnson does not recommend eating close to bedtime, as it can disrupt the circadian rhythm. Evolutionarily, the night was the time when our bodies rested and slowed digestion in order to restore energy and support brain function. That bedtime snack is actually causing more harm than good.

If you have neck or back pain:

For neck or back pain, there is no key sleeping position that will work for everyone. This is because back and neck pain typically have a different, unique cause for each individual. However, seeping on your back may offer the most benefits in terms of pain relief for most people. This is because sleeping your back evenly distributes weight across the entire body. This will help to minimize pressure points and ensure proper alignment of the head, neck, and spine. A small pillow underneath the knees can help to further promote proper alignment.

If sleeping on your back is absolutely impossible, try putting a pillow between your knees as you sleep on your side. This can help to realign your spine, hips, and pelvis.

Sleeping on your back has been proven to be the best for back pain, studies have shown that for older adults, those who sleep on their back noticed improvements to their pain issues in only 4 weeks.

If you have GERD or heartburn:

Gastroesophageal reflux, also known as GERD, tends to be worse at night. This is potentially due to the lack of gravity helping to keep stomach acid down. While you sleep, saliva production also slows down, which means less saliva to neutralize stomach acid. According to research, sleeping on your left side can help alleviate these problems.

The reasoning behind this is not totally clear, but researchers think it’s due to the positioning of the stomach on the right side of the abdomen. Sleeping on the right side gives the contents of your stomach direct access to the esophagus. But sleeping on the left side may prevent the stomach contents from crossing into the esophagus.

If you’re pregnant:

Pregnant women are typically advised to avoid sleeping on their backs after about 20 weeks. Sleeping in this position after about four and a half months can compress the inferior vena cava. The inferior vena cava is one of the major veins that return blood to your heart from your lower body.

Putting pressure on this vein can potentially reduce blood flow to not only the fetus, but also to the mother. Sleeping on the left side is most advisable to pregnant women, as this side is associated with increased circulation.

The Worst Sleep Positions

Research has demonstrated that the worst sleep position is face down, on the stomach. Around 7% of the population sleep like this. And while it may help to decrease the sound of snoring, this sleep position also comes with some negative health effects. Sleeping face down with your head on a pillow skews the spine out of a natural position, putting strain on your neck and back. The weight of the stomach will also cause the back to over-arch, further causing strain.

Over time, sleeping like this can lead to nerve issues and pain. You may begin to notice some tingling sensations or numbness in your extremities if you sleep in this position over time.

Sleeping in the fetal position is another sleeping position that comes with some negative health effects. While sleeping on your side has been linked to multiple benefits, the extreme curvature of the spine in the fetal position can lead to discomfort and strain in the back and neck. Sleeping tightly curled into a ball will also restrict space for the diaphragm and can lead to restricted breathing.

How to Sleep Well in Every Position

Even if you’ve been sleeping a certain way for years, you can take steps to improve alignment and rest:

• Side Sleepers: If you typically sleep on your side, you should invest in a softer mattress to support the neck and waist. This will also relieve pressure from your shoulders and hips. A contoured pillow will also help to keep your neck aligned with the rest of your spine. A pillow between your knees will help to alleviate pressure on your back.

• Back sleepers: If you’re a back sleeper, you should try using a harder mattress to support the lower back. If you’re pregnant or have GERD and typically sleep on your back, try investing in a wedge to elevate your head.

• Stomach sleepers: If you sleep on your stomach, you should only be using very thin pillows if any at all. A thin pillow or no pillow at all will help to prevent neck misalignment. A gentle, but firm mattress is also beneficial for stomach sleepers.

Paying attention to spinal alignment, ear, shoulder, and hip in one line, combined with good sleep hygiene, can improve sleep quality, reduce discomfort, and support overall health. Small adjustments to your position or bedding can make a significant difference over time.

For more guidance on sleeping through the night or to learn about healthy sleeping habits, contact us or call 276-235-3205 to schedule a complimentary discovery call.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!