a man sleeps on his back in bed

The Expert-Approved Way to Wake Up Refreshed and Pain-Free

Morning achiness isn’t as normal as you think it is.

Fast Facts

  • There isn’t one sleeping position that works for everyone, but there are specific pros and cons to each.
  • Back sleeping is the most medically correct sleeping position, as it keeps your spine in alignment.
  • Side sleeping is the most-preferred sleeping position while stomach sleeping is the least common.

It’s hard enough to get out of bed in the morning—add a stiff back and jammed neck, and it’s a recipe for a slow start. If you got the recommended seven to eight hours of sleep and your mattress is supportive, last night’s pretzel-like poses could be to blame. That means it all comes down to sleep position (sort of). Unfortunately, there isn’t a universally perfect way all humans should sleep, according to Abhinav Singh, M.D., M.P.H., F.A.A.S.M., medical director of the Indiana Sleep Center. However, the best sleep position for you does. You just have to examine your health and aches and experiment a little to find it.

Finding Your Best Sleeping Position

Textbook speaking, back sleeping is superior, as it’s a sure-fire way to keep your spine aligned and weight evenly distributed, therefore eliminating unwanted stress on the surrounding muscles and joints, explains Dr. Singh. “Naturally, our body is designed to sleep horizontally,” he adds. But compromising factors like body pain, health conditions (i.e. sleep apnea), pregnancy, and more keep many people from comfortably laying flat. And believe it or not, Dr. Singh says that’s totally fine. “As long as you wake up feeling good and no body part is hurting, that means you slept well however you slept,” he says.

Different Sleeping Positions and Their Impact On Your Body

Every sleep position has its pros and cons. And while back sleeping may be the most medically correct, side sleeping is the most common—according to a 2019 study, it’s preferred by 60 percent of adults (1). Stomach sleeping is the least common, accounting for less than 10 percent of our time asleep (2). But everyone moves around a little bit throughout the night—Dr. Singh says it’s normal to toss and turn between 20 and 30 times.

Sleeping On Your Left Side

Most gravitate toward side sleeping due to comfort and preference, but it’s crucial for pregnant people—especially during late-term pregnancy—to roll over. Experts say specifically sleeping on the left side with knees bent is best for those expecting (3), as it promotes blood flow to the heart, fetus, uterus, and kidneys while also keeping pressure off the liver and bladder. If sleeping on the left side is uncomfortable for a pregnant person, experts say turning to the right is OK, too.

Left side sleeping is also ideal for people with chronic acid reflux, according to Dr. Singh. One study found that the position presented fewer instances of heartburn than sleeping on the back and right side (4). In fact, participants who slept on their right side experienced more frequent and longer heartburn episodes than those who slept on their left.

Sleeping On Your Right Side

Some research shows that people with heart failure are better off sleeping on their right side (5) because sleeping on the left can impact the heart’s functioning, causing discomfort. Dr. Singh says he’s “not convinced” that these findings are absolute, adding that more research on the topic is warranted.

However, for those with sleep apnea, it’s critical to sleep on a side—whichever is most comfortable, Dr. Singh says. Sleep apnea is characterized by intermittent breathing irregularities, also known as “apneas,” during sleep, and side (or stomach) sleeping allows the airways to stay open, as opposed to back sleeping, during which gravity pushes the tongue to the back of the throat, blocking them. “For the snorer, it’s easier to breathe when they are on their side,” adds Dr. Singh.

Of course, there are negatives to side sleeping, too. Because it puts pressure on the shoulder touching the mattress, it can potentially cause shoulder and neck pain over time (6). Nick Dahl, D.O. a physician that works with Hone adds that side sleeping asymmetrically and misaligning the spine makes it “curve laterally in a way that’s unnatural,” which can cause lumbar stress that he likens to hours spent crouched over a computer.

Stomach Sleeping

Stomach sleeping leaves you more prone to neck, back, and shoulder pain than other positions (1). It also hyperextends your back as your torso sinks into the mattress, explains Dr. Dahl, which causes tension, especially over long periods of time. Still, that doesn’t change the fact that it’s some people’s preferred way of sleeping, which Dr. Singh approves of—as long as it doesn’t cause pain. People with sleep apnea are also better off sleeping on their stomachs (or sides) than on their backs.

How to Sleep When You Have Back Pain

Back pain is “a big box of issues” that expands “from the neck all the way to the mid-back to the lower back,” Dr. Singh explains. No single sleeping position can address all related aches, he adds, but back sleeping—and keeping the spine aligned—is the best way to ensure back pain is not exacerbated during rest.

Side sleeping may also provide relief to those experiencing mid to low back pain, Dr. Singh adds. The National Sleep Foundation recommends fetal position side sleeping with the knees slightly bent and a thin pillow between them to relieve pressure on the lower lumbar.

Regardless of what sleeping position you favor, having a supportive mattress and pillows are key to keeping you comfortable because ultimately, sleeping comfortably is key to waking up pain-free.

The Bottom Line

There isn’t a one size fits all approach to finding the best sleeping position for your health. But with a little observation and experimentation, you can find the sleeping position that works best for you and your body. While there are benefits to certain sleeping positions for specific conditions (such as sleep apnea and pregnancy), in general, whichever way you find it most comfortable to sleep—without aches and pains—is likely the best for you.
References:
1. Cary, Doug et al. “Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review.” BMJ open vol. 9,6 e027633. 28 Jun. 2019, doi:10.1136/bmjopen-2018-027633

2. Skarpsno, Eivind Schjelderup et al. “Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.” Nature and science of sleep vol. 9 267-275. 1 Nov. 2017, doi:10.2147/NSS.S145777

3. “Problems Sleeping during Pregnancy.” Medline Plus, medlineplus.gov/ency/patientinstructions/000559.htm. Accessed 13 May 2022.

4. Katz, L C et al. “Body position affects recumbent postprandial reflux.” Journal of clinical gastroenterology vol. 18,4 (1994): 280-3. doi:10.1097/00004836-199406000-00004

5. Leung, Richard S T et al. “Avoidance of the left lateral decubitus position during sleep in patients with heart failure: relationship to cardiac size and function.” Journal of the American College of Cardiology vol. 41,2 (2003): 227-30. doi:10.1016/s0735-1097(02)02717-1

6. Zenian, John. “Sleep position and shoulder pain.” Medical hypotheses vol. 74,4 (2010): 639-43. doi:10.1016/j.mehy.2009.11.013

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