The Perfect Sleep Position

I get this question a lot as a massage therapist, and it is always a difficult one to answer - is there really a perfect sleeping position? We need to consider that everyone differs in terms of posture, discomforts, and symptoms, and all have an effect on the position we choose to sleep in.

Instead of telling you that you should sleep in one position over the other, let’s optimize each sleeping position to help benefit you, no matter how you sleep. Back sleepers:

  • Consider sleeping with a pillow underneath your knees. This can help to decrease or flatten your lower back curvature and to prevent spinal rotations that occur with sleep, reducing the stress put through the spine.

  • A pillow underneath your head can be used to help support your natural neck curvature.

  • This may be an optimal position for someone with lower back discomfort.

Side-lying sleepers:

  • Support for the spine is very important in this position. Placing a pillow between the knees will help to take pressure off of the hips and the lower spine, keeping the two structures aligned. Depending on your body structure, this may also require a rolled towel or small pillow underneath your waist. Filling the gaps between your torso and the mattress may help to add more support.

  • Pillow height matters for your neck pillow as you want your neck to be aligned with the rest of your spine while you sleep. A pillow should span the distance between your ear and shoulder - a pillow that is too flat or too tall will keep your head out of neutral position for an extended period of time, causing strain of neck, back, and shoulder muscles.

  • This may be an optimal position for those that experience congestion or breathing issues while sleeping.

Stomach sleepers:

  • To encourage spinal alignment, consider placing a pillow underneath the pelvis helping to align the hips with the spine (to again, help decrease or flatten your lower back curvature).

  • The biggest issue here is forced rotation of the neck to the right or left for an extended period of time. This again can cause strain on neck, back, and shoulder muscles. You can trick your body into sleeping in the side-lying position by placing a pillow underneath one side of the hip (instead of fully under both hips), which may decrease the amount of rotation and stress placed on the neck.

  • A flatter pillow for the head would be suggested to avoid too much extension of the neck.

Fun fact: The placements of pillows discussed here are similar to how we would place them in a massage treatment! Placing you in the most neutral position allows us to treat your target areas with reduced tension on muscles and joints.

Note that the key to success is attempting to keep your spine as aligned as possible, while still being comfortable enough to sleep (as that is the most important part after all!). Ultimately, we will end up sleeping in the position that our bodies want to sleep in regardless of what is suggested to us. With that said, I am a huge fan of experiments! Experiment with the different sleep positions and pillows to find what helps make your sleep and/or symptoms better.

Have any question or concerns? Please get in contact with me by clicking here to discuss your specific situation.

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