The most popular sleeping positions and how your nighttime posture affects your health.
By Annie Hayes
Do you frequently kip in the foetal position? Or perhaps you simply can’t sleep unless you’re lying on your back? We all have our favourite sleeping positions – but your chosen posture might not be the best one for your health.
The way you sleep plays a key role in the quality of your kip, and the importance of solid shut-eye can’t be understated. Sub-par sleep can put you in a bad mood the next day, but long-term sleep deprivation can also lead to a number of health issues, from obesity to diabetes, and even shortens your life expectancy.
There are many reasons our sleeping positions might need to change over the course of our lives, from battling the common cold to alleviating back problems. Since different sleeping positions have different benefits, training yourself to adopt a new posture – or modifying your usual go-to – could be the key to a more restful night.
We spoke to Dr Lindsay Browning, sleep doctor, neuroscientist and author of Navigating Sleeplessness, and Julie Jennings Dip COT HCPC, occupational therapist for HSL, to find out how sleeping positions can positively and negatively affect your health:
What is the healthiest way to sleep?
Ultimately, the healthiest sleeping positions are the ones that allow you to wake up feeling refreshed, and that will be different for each individual. According to a report by the National Sleep Foundation (NSF), the key determinants of quality sleep are as follows:
- Sleeping at least 85 per cent of the total time you are in bed
- Falling asleep in 30 minutes or less
- Waking up no more than once per night
- Being awake for 20 minutes or less after initially falling asleep
As a general rule, ‘side sleeping is generally thought to offer the most benefits, and sleeping on your front should ideally be avoided,’ says Dr Browning. ‘Sleeping on your back is fine as long as you do not have any breathing problems, and as long as you have a supportive mattress to support your spine.’
Side sleeping is generally thought to offer the most benefits, and sleeping on your front should ideally be avoided.
However, there are a number of situations when it may be beneficial to deliberately try to sleep in a particular way. If you’re struggling with chronic pain, for example, switching sleeping positions might help you to manage it. In some instances, changing your posture can even act as a preventative measure.
For the ultimate night’s kip, make sure your mattress is suited to your particular sleeping style. ‘It should be firm enough to support your back, letting your shoulders and bottom sink into the mattress, ensuring that your spine itself stays straight,’ says Dr Browning. ‘Back sleepers may prefer a firmer mattress compared to side sleepers.’
Sleeping on your back
Good for: back health facial wrinkles, hip pain, heartburn.
Bad for: snoring, sleep apnea, lower back pain, pregnancy.
Known as the supine position, ‘sleeping on your back ensures that your spine, neck and head are all in alignment to maintain a natural position,’ says Jennings. ‘It’s the ideal position for your back health because of the neutral position that you’re maintaining. You can also place a small pillow underneath your knees if you find this more comfortable.’
However, sleeping on your back is also associated with lower back pain, especially if your mattress is not correct for this sleeping style, says Dr Browning. ‘Also, when someone snores, or has sleep apnea, then sleeping on your back can make it even worse,’ she says. ‘To prevent you from automatically rolling back onto your back, tape or stitch a tennis ball into the back of your pyjama top.’
If you prefer to sleep in this position, keep the pillows to a minimum. ‘We know most people prefer to have a couple of pillows, but using only one pillow is great as it allows for optimum breathing,’ says Jennings. ‘Any more than one pillow and you’re narrowing the oesophagus, which then leads to a reduced amount of oxygen.’
There are a number of different ways to sleep on your back:
💤 Soldier position
Sleeping on your back with your arms by your side is called the soldier position, and around 8 per cent of people sleep like this.
💤 Starfish position
The starfish involves sleeping on your back with all four limbs spread out. It’s the least popular sleeping position, with only about 5 per cent of people sleeping this way.
Sleeping on your stomach
Good for: Snoring, sleep apnea, hospitalised COVID-19 patients.
Bad for: Back and neck problems, joint and muscle pain, facial wrinkles.
This position is ‘a real no-no’, says Jennings. ‘By sleeping on your stomach, it’s almost impossible to keep your spine in a neutral position,’ she says. With your neck out of alignment, you’re prone to joint aches and pains. It also puts pressure on nerves, which can cause numbness, tingling and pain. If you do sleep in this position, the pillow beneath your face ‘should be extremely soft to minimise the angle in your neck,’ adds Dr Browning.
While side sleeping is best for preventing snoring and reducing sleep apnea, sleeping on your stomach may also help. Interestingly, research on patients with severe COVID-19 who were hospitalised on ventilators concluded that lying face down was better for their lungs. ‘When you lie on your front, this stops your heart and stomach from pressing down on your lungs and allows the air sacks within the lungs to fully inflate,’ Dr Browning explains.
Sleeping on your stomach is often referred to as the prone or freefall position:
💤 Freefall position
The freefaller is when a person sleeps on their stomach with their head to one side and their arms wrapped beneath the pillow. Around 7 per cent of people sleep this way.
Sleeping on your side
Good for: Snoring, sleep apnea, brain health, pregnancy.
Bad for: Acid reflux, heartburn, facial wrinkles, back pain.
Known as ‘lateral’ sleeping positions, whether you choose to kip on your left or right side can make a big difference to your health. For example, ‘sleeping on your right can increase your chance of acid reflux and worsen the effects of heartburn,’ says Jennings, while sleeping on your left actually reduces reflux episodes.
‘There are many benefits of this sleeping position for a comfortable and restful night’s sleep,’ says Dr Browning. Often the benefits are associated with the left side, but not always. ‘If you have heart failure, it’s important to avoid sleeping on your left side, and to instead sleep on your right side,’ she says. ‘When you sleep on your left side, the lungs can press onto the heart itself.’
Sleeping on your side is the most common sleeping position with more than half of people (54 per cent) doing so.
Sleeping on your side is also preferable for people who snore, Dr Browning says, ‘since that can keep the airway more open during sleep – reducing snoring’. And in rodent studies, it appears to be beneficial for draining waste products from the brain while you’re in the land of nod. It’s not all smooth sailing, though.
Unfortunately, sleeping on either side isn’t ideal for your back. ‘Your body will naturally want to twist and this can, in turn, lead to straining your pelvis and lower back,’ says Jennings. ‘By placing a pillow between your legs you will be able to reduce the threat of this leg twisting from happening. Shoulder pain can also incur from sleeping on your side.’
According to research, sleeping on your side is the most common sleeping position with more than half of people (54 per cent) doing so. There are a number of different ways you can sleep on your side:
💤 Foetal position
Almost half of people (41 per cent) sleep in the foetal position, which involves lying on your side with your legs curled up like a baby. Despite its popularity, it’s said to be one of the worst sleeping positions for back issues because it opens up the posterior structures of the spine, where most back problems occur. Although lying in this position might help to reduce symptoms, you will notice more pain when you attempt to move.
💤 Log position
Ever heard the expression ‘sleep like a log’? Around 15 per cent of people take this literally, lying on one side with their legs extended straight and arms in place by their side. This is a good position for those people who need to keep their back and neck aligned but may be bad for arthritis.
💤 Yearner position
Thirteen per cent of people sleep on their side with their arms stretched out in front. While this is good for your breathing, it may also be bad for arthritis.
💤 Spooning position
A side sleeping position for couples – comprising one ‘big spoon’ at the bag and one ‘little spoon’ at the front – spooning has certain advantages and disadvantages. It releases oxytocin, which boosts bonding and quells stress, but can become uncomfortable over time and could result in disturbed sleep.
What is the best sleeping position?
The best sleeping position is whatever feels comfortable to you. However, if you’re struggling with an injury or other health issue, certain sleeping positions might help you manage it:
😴 The best sleep position for wrinkles
If you’re concerned about facial wrinkles, avoid sleeping on your stomach or side. Any position that forces your face into the pillow can stretch your skin over time, so stick with back sleeping if you can. If you really can’t bear sleeping this way, the log position may also minimise the risk of wrinkles, since there’s minimal contact with the pillow.
😴 The best sleep position for snoring and sleep apnea
Sleeping on your back can aggravate these conditions, so side sleeping is best for people who snore or suffer from sleep apnea (remember, the two can be interlinked – severe or loud snoring may be a sign of sleep apnea). One study found that the lateral sleep position reduces the severity of sleep apnea, ‘due to changes in pulmonary oxygen stores’.
😴 The best sleep position for back, neck and shoulder pain
Sleeping on your back with a pillow beneath your knees is generally best for back, neck and shoulder pain. Your choice of mattress is also key. ‘How we sleep is important for our posture – you should sleep on a mattress that is flat or very slightly angled at the head end, and has the degree of firmness that allows the natural slightly S-shaped curve of the spine to be maintained,’ says Jennings.
😴 The best sleep position for pregnancy
Sleeping on your stomach will be uncomfortable at first and near-impossible as your pregnancy progresses, so stick to your side – ideally the left, which is beneficial for circulation. ‘Pregnant women, post 28 weeks, should avoid falling asleep on their back, since there is an increased risk of stillbirth,’ Dr Browning says. ‘This is thought to be related to the flow of blood and oxygen to the baby.’