What Is The Ideal Sleeping Position For Falling And Staying Asleep?: A Mattress Expert Weighs In

A lot of readers write to me asking which sleeping position will help them fall asleep, minimize tossing and turning, and reduce interruption of our most restorative level of deep sleep, called REM sleep. 

There’s been a lot of research conducted on this topic, and while people have individual preferences based on their body types, physical condition, and their sleeping partners preferences, too, a lot has been learned recently about the topic.

Let’s take a look at the benefits of each sleeping position, general described as back, belly, and side sleeping, although fetal position might be considered its own category:

1. Back Sleepers: Lying on your back and assuming a neutral body position typically minimizes the strain placed on your head, neck and spine. It also helps evenly distribute load across a broader plane, and reduces pressure points for many people. However, studies show links between back sleepers and snoring and sleep apnea, because your tongue falls to the back of your throat, due to gravity pulling your chin downward. This can, in fact, be a deadly sleeping position for many people.

2. Side Sleepers: Sleeping on your side is the most is the most common position for adults, and allows our airways to expand, providing steady and unobstructed airflow to the lungs. If you snore or have sleep apnea, this is likely the best all around sleeping position for you. One down side: Side sleepers can develop facial wrinkles due to the pressure your pillow places on your skin. Often, women, who are trying to prevent wrinkles from worsening, sacrifice the benefits of side sleeping and try to remain on their backs. The fetal position is also just as bad for wrinkles, too, as your face is pressed into your pillow or your mattress.

3. Fetal Position: The fetal position has been shown to improve vascular flow and is a good option for people who tend to snore or for pregnant women. My advice is to make sure that you don’t tuck your knees too excessively as this can reduce your oxygen saturation by causing shallow breathing, and can also cause muscle tightening, resulting in lactic acid buildup causing morning aches and pains.

4. Belly Sleepers: Although the school of thought has always been that sleeping on your stomach could make breathing a challenge because airway passages could be compromised, the medical community has learned a lot during the COVID pandemic. Belly sleeping is medically known as “proning”, says Dr. Nicholas Caputo. He’s the associate chief at New York City Health and Hospitals/Lincoln Medical and Mental Health Center’s department of emergency medicine. How does it work? Gravity, says Caputo. “It makes sense anatomically,” he noted, “because when your body is parallel to the ground all the organs lay off of it like on a clothes line. So, by flipping over or to your side you open up the areas, like your lungs, that would otherwise be compressed when you’re on your back.” In a medical setting, prone position is likely ideal, and if you are a lifelong belly sleeper, you’re probably in good shape, and likely fall asleep with ease, tending to remain asleep and stationary, moving your arms and legs occasionally, but keeping your torso in a constant prone state. The fact of the matter is, though that many people cannot sleep on their bellies because it cannot promote back pain due to arching of your spine, particularly if you are sleeping on a mattress that is too soft. I recommend that belly sleepers use the firmest mattress that you can tolerate to maintain straight and level spine alignment.

 

Side Sleeping Is Likely The Overall Best Position To Improve Sleep Quality, Help With Sleep Induction, And To Help Remain Oxygenated During the Night.

If you’re a side sleeper, you likely fall asleep faster, and generally remain still, occasionally flipping sides once very few hours. This happens as your body begins to feel pressure in areas where there is a lot of weight concentrated, like along the shoulders and hips.

Some sleep experts do not advise side sleeping in general, calling it the ‘razors edge” because you are concentrating  weight along a very confined area, but, if you have the right mattress, this is really not an issue. 

A mattress that cradles your body allowing for a little bit of immersion, such as a mattress with either natural latex or a medium soft gel or memory foam layer up top can help with this. You still want a fairly firm base layer, though to help keep your spine straight and to prevent gulling and depressions that can keep you from comfortable moving during the night to change positions.

Side sleepers experience an open airway that is not compressed, your oxygen saturation remains high, and you are feeding your body the necessary nutrient it needs to repair tissues, especially neurons in the brain, as you sleep. 

Your tongue is forward and off to the side, allowing a clear airway, and not obstruction your breathing which is potentially dangerous for sleep apnea sufferers and annoying to your partner, especially if you are an obnoxious snorer.

But, how can you switch your pattern of sleep, and ultimately permanently change your position preference? While changing your default sleeping position is no easy task, you can help the process by supporting your head and legs with pillows designed for your ideal position.

Essentially, you are forcing your body to remain in the new position. If you’re a back sleeper for example, and want to make the switch to side sleeping, you can simply pack a few pillows (borrow some throw pillows from the couch if you need to) directly behind your back to prevent flipping yourself to the back position.The adjustment process can take up to 14-21 nights of sleep, so be patient, and if you hang in there, you’ll notice the benefits of side sleeping almost immediately.

Regardless of your go-to sleep position, getting adequate rest is important to all aspects of your health, as our sleep time enables our bodies and minds to heal, regenerate, rapid, and process and store memories.

Chiropractors and physicians aggressively promote side sleeping as the overall bed sleeping position, as well.  Because side sleeping keeps your spine straight and aligned, and promotes a more consistently open airway, it is considered excellent for improving sleep induction, too, that often elusive phenomenon of falling asleep.“It will help prevent stress points that may aggravate joints and connective tissue,” says Dr. Robert Hayden, Georgia-based chiropractor and American Chiropractic Association spokesperson. 

Additionally, side sleeping is crucial for those who snore or suffer from sleep apnea since it’s an effective way to keep your airways open, says Dr. Natalie Dautovich, assistant professor of counseling psychology at Virginia Commonwealth University and environmental scholar at the National Sleep Foundation. If you’re pregnant, side-sleeping isn’t only a great way to relieve pressure off your belly. A 2012 study from BMC Pregnancy & Childbirth found that sleeping on your left side specifically can help promote oxygen flow to both the mother and fetus.

I always recommend a natural latex pillow for a little bit of springiness and bounciness, or a memory foam pillow if you enjoy a little more immersion. I’ve used a low profile natural latex pillow for nearly 20 years, and always pack it in my suitcase for travel. I review a bunch of great pillows on my pillow review page that you can check out, too.

If you’re a GERD sufferer, you likely have been told to stack a few pillows under your neck to raise you head up to prevent reflux, but I advise against this. Your best bed it to find a wedge that you can place under your mattress which increase the angle of your overall mattress and not a sudden tight angle which can constrict your airway and cause neck and head pain. 

“Definitely avoid stacking pillows” says Dr. Kristina Petrocco-Napuli, Florida-based chiropractor, and President of the ACA Council on Women’s Health. 

When you’re sleeping, your head and neck musculature becomes limp and very relaxed. According to Dr. Hayden, if your head, which weighs between 13 and 15 pounds, isn’t level with your mattress and you’re sleeping on your side, stress points develop along the joints in your neck. 

There is, however, a “wrong” way to sleep on your side. If you have a habit of sleeping balled up in the fetal position, Dr. Dautovich says it can restrict breathing by limiting the movement of your diaphragm. It can also place unnecessary stress on your joints and leave you feeling sore the next day.

“You can reduce the strain on joints by straightening your body as much as possible,” says Dr. Dautovich. In addition, avoid putting your weight on your arms while you sleep, since this can lead to circulatory issues like a feeling of numbness or pins and needles. If possible, try sleeping with your arms folded into your chest.

If you’re not a current side-sleeper, you may be at risk for developing prolonged pain the next day, caused by lactic acid buildup, and stiffens. Improper sleep posture can impact your emotional, psychological, and cardiovascular health as well. “Certain hormones are designed to ebb and flow during the sleep cycle,” explains Dr. Hayden. “Growth hormones regulate the production of hormones that we use to repair tissues and heal, [which are] secreted during stage IV of the sleep cycle.” 

Ultimately, if you don’t get into REM sleep, which happens within an hour or so of falling asleep, or if you are constantly moving, shifting, and interrupting this critical stage of sleep, “you may find yourself gaining weight, getting sick and staying sick more often, and eventually having changes in your cardiovascular system such as hypertension,” he says.

“Fatigue itself will make you not feel your best,” Dr. Hayden says. “The physical aspects of your health will spill into the emotional and mental aspects. When you feel your best physically, you’re more likely to have a positive self-image.”

Bottom line, many people simply cannot make the switch to side sleeping, often due to their anatomy, various medical conditions, or for other reasons. At the end of the day, experts tend to agree that comfort is most important, especially if you are trying to squeeze the most productive level of sleep you can get out of your night. . Other postures like sleeping on your back can also be beneficial if executed properly, and if you don’t have medical conditions like sleep apnea, for example.

If you are doomed to sleep on your back, I recommend placing a pillow under your head and under both of your knees in order to support your spine and keep it as straight as possible. 

If you want to learn more about finding the right mattress to help you sleep more restfully, check out my curated list of Trusted Dealers. Each option gives a very quick bullet point assessment of the mattress I have reviewed and also gives insight as to whether or not the mattress is ideal for side, back, or belly sleepers.