As daylight savings time comes to an end and we prepare to set our clocks back an hour, many people look forward to dedicating their extra hour of time to a good night’s sleep. This is an opportunity to consider the overall importance of good sleep posture as it relates to our musculoskeletal health. If you have ever woken up with a randomly sore back or stiff “kink in the neck”, then you already understand that sleep position can play a large factor in musculoskeletal pain and dysfunction.
Having correct posture during sleep is just as necessary as having good posture while awake as it reduces unnecessary stress on the body’s joints, muscles, and ligaments. Considering that the average person spends almost one-third of a lifetime sleeping, it is crucial that proper sleep ergonomics be used as much as possible to limit these problems and to wake up feeling more relaxed and rejuvenated. Regardless of sleep position, it is ideal to sleep on a reputable mattress that provides comfort and support for the 3 normal curves of the spine in the neck, mid-back, and low back. For most people, having a mattress with a firmer base layer and soft top layer is adequate.
Sleeping on the back is considered to be the best sleeping position for the spine as it naturally keeps the vertebrae in alignment while reducing any unnecessary bending or rotational forces. With the nose pointing to the ceiling, this position should include one fluffed pillow placed underneath the neck curve (not just underneath the head) so that the neck feels cradled and supported. Two additional pillows should also be stacked and placed underneath both knees, as needed, to help relax and relieve any low back tension or pain.
The next best sleep position is side sleeping posture and is often the best alternative for people who cannot sleep on their backs, such as those with sleep apnea. In a side-posture position with the head and neck both resting on a fluffed pillow, the head should be in-line with the rest of the spine (ears aligned over the shoulders). It is important to use a pillow that is neither too fluffy nor too flat, as these options will raise the head away from the bed or let the head fall toward the mattress respectively. A second pillow should then be placed in between the knees (while slightly bent) to support the upper leg and to keep the lumbar spine and pelvis from tilting or rolling out of alignment. The arms should not be raised above the shoulders or head in this position in order to prevent shoulder issues and should instead be placed in front of the chest where comfortable. It is also not a good idea to sleep in a curled up fetal position, though side-lying, as this greatly reduces the normal curves of the neck and low back while creating strong muscle imbalances over time.
Lastly, sleeping in a face-down position is the worst position for spinal health and should not be used if possible. The primary concern is excessive rotation of the head and neck, causing too much joint stress and loss of neck curvature over time. Likewise, the pelvis and low back can become rotated to a lesser degree while attempting to make the knees comfortable. If one must sleep face down, it is advised that he/she at least attempt sleeping with the head only slightly turned while keeping the airway open.
Ask your chiropractor for more tips on how to sleep correctly so that you can move better, feel better, and live better!