Here are some tips on how to set yourself up for a successful night of sleep based on your sleeping position.

Most of us have heard that sleep is good for us, but sometimes even things that are good for you can cause you a little pain every once in a while. Remember the time you woke up with a kink in your neck? Or some ache in your shoulder? Or some back pain? And then throughout the day, it seems to “loosen up” or just disappear after a few hours. Maybe the way you are sleeping is actually making you sore.

The body likes movement. I like to say that motion is lotion for the body. Most of us are pretty aware that sitting in one position for 8 hours straight while working can cause some aches and pains. This is the same thing after sleeping for 8 hours. So let’s look at ways to set yourself in the best possible position.

I have heard many of these questions before: What is the best sleeping position? Is there 1 ideal sleeping position? Is it bad to sleep on my stomach? Can I really change my sleeping habits after all these years of sleeping the same way? Why do I wake up with this ache and then it just gets better throughout the day?

Now, I am not here to tell you what personality traits you have based on your sleeping position (there are plenty of those kinds of articles out there), but I will try to give you some tips on ways to make opening your eyes to the blaring alarm a little less painful based on the position you sleep in.

Back Sleeper

  • Do not use a big fluffy pillow under your head. This puts your head and neck really far forward. Imagine that you are sitting there looking down towards your belly button. Now do this for 8 hours straight. I think you could imagine that your neck would be pretty sore.
  • Instead, use a fairly flat pillow under your head.
  • Consider adding a small rolled-up towel at the bottom of your pillowcase. The back of your head would be mainly on the pillow and not on the towel. If you have ever seen a picture of a spine or a neck, you probably have noticed that there are some normal curves in that spine. Adding a small rolled-up towel at the bottom of the pillowcase can help support that curve in your neck.
  • Add a pillow underneath your knees. This could help put your lower back in a more neutral position.
  • Consider adding small pillows underneath your elbows. Make sure the pillow is not underneath your shoulders. This could help put your shoulders in more neutral positions and could help with front of your shoulder pain or chest muscle tightness. Sometimes when you are lying with your elbows flat on the bed, this can put your shoulders in relative extension (think of this as reaching straight back behind you).

Side Sleeper

  • Use the correct size pillow for your head. Let’s imagine that you are lying on your right side. If the pillow is too large, this would be the same as tilting your head to the left for the whole night (your left ear getting closer to your left shoulder). Now, if the pillow is too small, it would be the opposite which is more like tilting your head to the right. The correct size pillow will keep your head in alignment with your spine.
  • Again, consider adding a small rolled-up towel at the base of your pillowcase. When you look at yourself in the mirror, generally the sides of your head (think your ears) are wider than the sides of your neck. Adding the small towel will help support your neck while the pillow supports your head.
  • Put a pillow underneath the arm that is closest to the ceiling (in the right sidelying example of this would be the left arm). Without the pillow there, most people have the tendency for gravity to pull the left arm down towards the mattress. This is like trying to reach across your body to scratch your back for the whole night.
  • Do not lie directly on your shoulder. It may be helpful to wedge a pillow behind your back and lean slightly back onto that pillow.
  • Add a small pillow underneath the side of your stomach. Generally, your hips are going to be slightly wider than your stomach, this is similar to the example of the towel underneath the neck. So, when you are lying on your side, you can add the small pillow to help support and keep the spine and hips in a neutral position.
  • Put a pillow in between your knees. This helps keep the knees, the hips, and the pelvis in a much happier position.

Stomach Sleeper

  • This may be the sleeping position I would recommend to avoid when possible. You may be saying, “I have been sleeping on my stomach all my life, and you expect me to change that now? That is impossible!” So, let’s say you are a passionate stomach sleeper, you can not change that, you will not change it, and you swear it is the only way you can fall asleep. And you are not going to let a stranger tell you to change that. So let’s talk about some tips for setting you up in the best position.
  • Place a firm pillow underneath your chest and stomach. This lifts your body slightly while making it a little easier to position your head. You could also place the pillow to bias underneath one shoulder instead of directly underneath your chest and stomach.
  • Then try placing a pillow propping up the backside of your head. This will point your nose slightly more towards the bed instead of angled straight towards your shoulder or straight down into the mattress.

Remember that it takes some time to change habits, especially habits that occur when you are sleeping. So the best thing you can do is try to set yourself up in the best position for a few nights in a row. This will allow your brain and body some time to try to adjust to the new set up. Having a couple of different pillow sizes and firmness levels could be helpful to test out what works best for you. This will also let you change your positioning throughout the week. Sometimes you might feel like sleeping on your back and the next on your side.

You can make an appointment to see a physical therapist to assess your sleeping set up, or to assess other reasons you might be having those morning aches or pain.

About the Author

Joshua Kingrey

PT, DPT

Josh graduated from San Jose State University (SJSU), where he earned his Bachelor of Science in Kinesiology with a pre-professional emphasis. Josh then earned his Doctorate in Physical Therapy from Samuel Merritt University. Josh grew up playing sports and continues to have a high interest in maintaining an active lifestyle. He believed that physical therapy was the career path where he could combine his interests in being active with his interest in helping to better the community. He enjoys helping people figure out how to best get back to the activities they desire. In his free time, he likes going to the gym, playing basketball, going hiking, and trying new activities with his friends. He can easily get lost in spending too much time watching Bay Area sports.

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