Sleep Positions: Which One Is Best?

I’ve been looking into sleep positions lately, mostly because I see posts on Facebook from one highly questionable source or another, claiming that a particular sleeping position can cure everything from fibromyalgia to migraines. These articles are always full of false mysticism and garbage, but what position you sleep in can affect your health. Here are just a few reasons science has come up with to consider one position over another:

Left side:

Alzheimer’s and Other Neurological Disorders Not only does getting poor sleep lead to worse outcomes in Alzheimer’s and dementia, how you sleep could factor in as well. A study in the Journal of Neuroscience showed that the brain’s cleaning system (the glymphatic system) works much more efficiently when sleeping on your left side than when sleeping on your front or your back, and also more than on your right side. Over an extended period, this could mean a much lower chance of Alzheimer’s and other neurodegenerative diseases for those who sleep on the left side. And for those that already have such a disease, changing what position you sleep in could slow progression. (Study: The Effect of Body Posture on Brain Glymphatic Transport)

Acid Reflux and Digestion This is one I know firsthand. There have been several studies showing that sleeping on your left side can ease heartburn symptoms. In this position, the stomach is positioned below the entrance to the stomach from the esophagus. This is important because symptoms of heartburn are caused when the stomach contents back up into the esophagus, so sleeping on your left side can prevent that from happening. In addition to heartburn, gastroesophageal reflux may also be associated with nocturnal wheezing, chronic nocturnal cough and sleep apnea. (Study: Aspects of Sleep on the Digestive Tract, and another study in JAMA Internal Medicine)

Decreased Risk of Stillbirths It is highly recommended for pregnant women to sleep on their left side, especially in the last trimester, the most important reason being that a couple of studies have shown a decrease in stillbirths in women who reported sleeping on their left side. It can increase blood flow to the placenta, ease acid reflux and nausea, and aid in digestion. (Study: Association between maternal sleep practices and risk of late stillbirth)

Either side:

Back and Neck Pain Chronic pain is one of the leading causes of insomnia, and we know that not having enough sleep can lead to more pain, so it’s no surprise that it can lead to a vicious cycle. (See my previous interview with Dr. Jon Robertson on chronic pain and sleep disorders) Sleeping on your stomach will only make matters worse. Try sleeping on your side with a pillow between your legs.

Snoring and Sleep Apnea If you snore or you have sleep apnea, you probably already know that sleeping on your side is best, but I wanted to cover all the bases here. (University of Maryland Medical Center)

Sinus Pain This is another bit of old news, and if you’re like me, you discovered long ago that sleeping on your side can help with the pain. Lay on your side, propped up (also hugging a pillow can help in this position). (American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015)

Sleep Paralysis It has been shown that those who are prone to sleep paralysis are far more likely to experience an episode while lying on their back to sleep. If you’re prone to SP, it’s best to sleep on your side. (The Sleep Paralysis Project)

Right side:

If You’re At Risk for a Heart Attack Sympathetic nervous system activity is lower in patients with chronic heart failure and in those who have had a heart attack when they lie on their right sides versus their left. The sympathetic nervous system controls heart rate and blood pressure, so the thinking goes that lying on the right side reduces the heart rate and blood pressure, which is ideal for patients at risk. (Journal American College of Cardiology)

Back:

Back Pain If you naturally sleep on your back, and the previous things on the list don’t apply to you, then sleep away! (Link) But be careful. There is some evidence that sleeping on your back may worsen lower back pain.

Wrinkles If your biggest concern is wrinkles, then congratulations! You’re quite healthy, and have no family history of Alzheimer’s, other neurodegenerative diseases, or heart disease.  The bad news is that you’re reading this blog, which means you’re probably having sleep issues, which means you should go back and read the bit about Alzheimer’s and neurodegenerative disorders because not sleeping well puts you at higher risk for those.

Fetal Position:

• If you absolutely can’t sleep on either side without pulling your knees up and bending your back, then you have an excuse to sleep in this position. But you should try to gradually wean yourself from this sleep position (pillows often help to keep you positioned correctly and comfortably).

Stomach:

• Don’t do it. It may help with snoring, but so does sleeping on your side. Sleeping in this position puts stress on muscles and joints, and can lead to back and neck problems, as well as irritating nerves, which can cause numbness, tingling, and lots of pain.

Combination positions:

• You’ve read this far, so let’s face it, you’re probably suffering some serious sleep issues. What’s important to remember is that, if none of the really serious things above apply to you, and if your sleep position works for you, then that is your major concern right now. You can work on positioning when you can actually get some real sleep.