Discover Your Ideal Sleep Position—Then, Train Your Body to Use It thumbnail

Discover Your Ideal Sleep Position—Then, Train Your Body to Use It

Getting your body into the proper sleep position is one of the best things you can do for your health. But we are, above all, creatures of habit, and changing the bedtime posture you’ve held for much of your life isn’t easy. If you can do it, though, it may well lead to dramatic improvements in not only sleep quality but also your overall health.

Here are five good reasons to change your sleep position—and three ways you can do it.

1. Consider side-sleeping if you snore

Side-sleeping can actually save your life if you’ve got severe sleep apnea, said Arie Oksenberg, PhD, director of the Sleep Disorders Unit at Loewenstein Hospital in Raanana, Israel.

When you sleep on your stomach or back, gravity works against you by compressing your airways. This is one of the prime causes of snoring, but it also leads to all sorts of other sleep issues. This is one reason why the best way to sleep is floating in midair. Astronauts consistently report decreases in both respiratory interruptions and snoring during compression-free, weightless slumber.

That’s why Oksenberg strongly recommends that people with breathing problems, like sleep apnea, learn to sleep on their sides. According to a 2014 paper Oksenberg co-wrote for the Journal of Sleep Research, patients who slept on their sides reduced or even eliminated the number of times their breathing was compromised during sleep. (Approximately 38,000 people in the US die annually from heart disease with sleep apnea as a complicating factor, reports the American Sleep Apnea Association.)

2. Consider back-sleeping if you have shoulder or back pain

If you’ve got muscular or skeletal discomfort but don’t have breathing issues, back-sleeping may be your best option. Assuming you have a supportive mattress, back-sleeping can promote better spinal alignment—helpful for folks with disc or vertebrae issues—and reduce pressure on injured limbs. People with a torn rotator cuff often wake up in the middle of the night when side-sleeping, since your body weight concentrates on a single pressure point, causing pain. (Read our full guide to back-sleeping.)

3. Consider left-side-sleeping if you have acid reflux or heartburn

If you’ve got gut problems, experts say the best way to sleep is often on your left side. That’s because the digestive system isn’t centered in your body, and sleeping on your left side allows a less-obstructed pathway as food you’ve eaten works its way through your gut. Stomach acid is less likely to bubble back up your throat when you’re sleeping on your left side. Back-sleeping is also an option for acid reflux, but you’ll need to arrange your pillows to gently elevate your head above your tummy.

4. Consider side-sleeping if you have high blood pressure

There’s a promising amount of evidence that getting a person to shift from stomach-sleeping or back-sleeping to side-sleeping can result in lower blood pressure. During a recent study, Oksenberg said, “We took 24-hour blood-pressure data, and the results were that both people with normal and high blood pressure showed decreases” after sleep-positioning therapy. (Oksenberg added that the connection between sleep and blood pressure is fairly well established, though the reason for that connection is still poorly understood.)

5. Consider side-sleeping if you’re young and have no problems at all

Given the benefits of proper sleep positioning, if you’re a stomach-sleeper, it probably pays to work on your sleep posture while you’re young. “It makes sense to learn to sleep on your side now so you can avoid development of problems that increase with age and weight gain,” Oksenberg said.

It’s not necessarily that young people will benefit immediately from side-sleeping. But they’ll reap the dividends later in life by training themselves early.

But how do you change your sleep position?

“It’s hard to do,” said Aleksandar Videnovic, MD, director of the Division of Sleep Medicine at Massachusetts General Hospital in Boston. “It’s a habit we’ve developed since infancy.”

As such, changing your sleep position might actually require a combination of training, the use of mechanical or electronic devices, and the proper selection of bedding; most likely, you’ll have to mix and match these techniques (and you should talk to your doctor about sleep positioning, especially if you have or suspect you have sleep apnea).

You should also understand that nobody sleeps in any single position all night long. Most folks change positions between 10 and 40 times nightly. And we tend to go back to our “instinctive” postures—which, for about 50 to 70 percent of us, is on our backs most of the night, depending on which study you’re consulting.

A note on back-sleeping: A lot of this advice would indicate that side-sleeping is superior. And in many cases, it is. But if you are healthy and have no breathing issues, there’s no immediate problem with back-sleeping, Videnovic said. (As noted above, though, learning to sleep on your side could be helpful as you age.)

If you want to change your sleep position, the results will likely be incremental but worthwhile. Here are three ways to do it:

1. Use a physical object to force your body into a new sleep position. The primary method for back- or stomach- to side-sleep conversion is called the “tennis ball technique,” and it’s exactly what it sounds like. You sew a tennis ball into the back (or front) of your pajama top, and that keeps you from rolling around. Studies show that the approach works, but one warning: The results may not stick, and you might need to repeat the treatment every once in a while. (One study showed that while most people gave up on the technique after two years—likely due to discomfort, because who wants to sleep with a tennis ball jabbing into their spine?—the method is effective for those who stay with it.) Similar methods use a foam bolster, backpack, or fanny pack to disincentivize back-sleeping.

2. Zap yourself into a new sleep position. Of course, there are high-tech versions of the tennis ball method. Strapped to your body like a heart-rate monitor, these devices learn your sleep habits and then use the data to vibrate when you roll into the wrong position. A 2015 study in the Journal of Clinical Sleep Medicine showed that while both methods worked equally well at getting people to not sleep on their backs, the electronic device encouraged longer-term compliance. And because it provided earlier, more gentle feedback, it resulted in better overall sleep. Given the dangers of sleep apnea, that’s a plus.

“Compared to … the TBT [tennis ball technique] … disease alleviation, sleep quality, and quality of life are significantly improved with the [electronic device],” write the study’s authors. Several other companies make similar devices, and while we haven’t tested any of them, recent studies have shown them to reduce sleep apnea by more than 50 percent in most users.

How do you get one of these devices? Some are classified as sleep aids, which means they don’t require a prescription; others are specifically designed to address medically diagnosed insomnia or sleep apnea and need to be recommended for you by your doctor. Among those currently available are the Philips NightBalance and the similar Night Shift devices. There’s also some overlap between these gadgets and those that help reduce snoring (see our tests of the latter).

3. Use bedding to mold your body into the right sleep position. Pillow and mattress choice are critical to sleep positioning. For example, back-sleepers usually prefer a firmer mattress, while side-sleepers need more cushioning to relieve the extra pressure on their shoulders and joints. If you want to change from back-sleeping to side-sleeping, you may need to get a softer mattress (or a mattress topper) to be comfortable. (We have guides to the best mattresses for side-sleepers, back-sleepers, stomach-sleepers, and people with back pain.)

Back-sleepers will want a pillow that isn’t too puffy but conforms to their bodies so that their head, neck, and back are aligned with each other. That could mean a memory-foam pillow placed to create a gentle, supportive line from your head to your shoulder blades (some folks prefer a buckwheat-filled pillow for this). Memory-foam mattresses can also help, as the dent you make in them acts to contain your body movements. Extra pillows, positioned as a sort of cordon to prevent shifting, are another option, but unfortunately, they’re not so good for cuddling if you’ve got a bed partner.

A pillow at your legs can provide support. Videnovic recommends placing one under your knees for back-sleeping—it’ll improve spinal alignment—or between your knees for side-sleeping. (A body pillow is another option for side-sleepers.)

Once you’ve found the ideal sleep position, you’ll have to work to keep it. Though there’s some evidence that electronic positioning devices “hold” longer, the reality is that you’ll need to monitor how you sleep and retrain yourself when needed.

Scientists and doctors are just beginning to understand the importance of sleep. “We’ve completely ignored a third of the 24-hour cycle of the day,” Videnovic said. “But we’re beginning to understand that the sleep cycle—which includes positioning, quality of sleep, and duration of sleep—is a modifiable target for therapy for a lot of disease.”

It may seem like a dream to be able to improve your health and well-being while you sleep. But if you’re willing to change some long-held positions, that’s entirely possible.

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