Continuing on from part of last week’s camping blog, we would like to expand on the topic of sleeping positions. This is an important subject that we speak to patients about every week, and we thought it deserved its own blog posting.
Most people don’t link sleeping postures with back or neck pain, unless it is obviously bothering them every night or in the morning when they wake. Our daily postures are quite important, as you all know, but so is our nightly posture. If, on average, we spend 8 hours per night sleeping, then we spend roughly 1/3 of our lives in various sleeping postures. We have already covered a topic on desk postures (which some of us also do for 8 hours per day), so let’s now delve into the best sleeping positions for maintaining spinal health.
On your back – This position allows your spine to remain in a straight, balanced, neutral position. People who have an increased low back curve (lumbar lordosis) may not find sleeping on their backs very comfortable. However, if you put a pillow under your knees to flatten your back out and create a neutral pelvic position, it may ease some of the tension in your low back. If this position causes troublesome snoring or other breathing problems, it is best to consult your medical doctor to examine the possible causes.
On your side – We recommend sleeping with your knees relatively close together if you sleep in this position, but it’s less important how much you bend your knees and hips (fetal position or fairly straight legs…whatever feels most comfortable). This position helps to keep your legs, pelvis, and lumbar spine aligned and balanced. A lot of “side sleepers” tend to spread their legs by raising one and straightening the other, which can lead to some low back (lumbopelvic) rotation as their bodies roll forward into a half-on-their-belly position. This position can cause a twisting of your pelvis followed by a rotation of your lumbar spine, which then leads to misalignments, and these misalignments can start, or perpetuate, low back and/or pelvic pain. Additionally, this half-forward position can also cause some prolonged neck rotation as your body rolls forward and your head remains sideways in order for you to breathe comfortably. It can help to place a small pillow or part of your quilt between your knees to prevent you from rolling forward too much, and that also keeps the pressure of your knees pressing on each other from becoming irritating. As previously stated, your knees should be relatively close together, but if you find it more comfortable with one a few centimeters in front of the other as opposed to directly side-by-side, that’s okay and not too hazardous for your spinal alignment.

Here is an example of a useful body pillow to keep a neutral spine while sleeping on your side. You can hug the top part to prevent your upper back from rotating over too much, and you also have a pillow between your knees. These can be especially good for pregnant women. We have more information on these types of pillows in our office.
On your belly – Well, we generally don’t have good advice for this, as it is the worst posture to be sleeping in for your low back and your neck. This position can increase the lumbar lordosis, thereby increasing the pressure on the discs and nerves and compressing the spinal facet joints. It also keeps your neck in a prolonged position of near maximum rotation. A small pillow, or a folded towel, under your belly can help to reduce the lumbar compression, but it’s still a difficult position for your neck.

If you feel you’re sleeping in a bad position, try to experiment with other sleeping postures when possible. And be very patient…it’s very difficult to break old habits and change your sleeping position, but if you’re consistent with it for weeks and months, the new positions become more automatic and easier to return to while turning over in your sleep. Of course, changing your sleeping posture is only one part of the remedy for low back or neck pain. If you suffer from either of these problems, it’s best to consult a chiropractor (like us!) to make sure your spine is properly aligned.
We hope this was helpful. If you noticed, we didn’t get into neck position and pillows. That’s because we’ll be giving our advice on the best pillows for your neck and sleeping position in our next blog post, so please watch for it!