Sleep Impacting Posture: And The One You Always Want To Avoid

Sleep Impacting Posture: And the Position You Always Want To Avoid

I received one of those fitness trackers for Christmas a few years ago. My husband and I wore them religiously and what started out as some friendly “stats comparison” turned into a fierce throw down. I can remember one evening when we were minutes from retiring to bed I heard him in the hallway. “Watcha doin’, honey?” I asked him. “Oh, nothing.” I threw open the door and there he was, in his boxers, pacing the hallway to get more steps for the day. “I knew it!!” I yelled.

Luckily, the novelty wore off for both of us, and both trackers now are in repose in the junk drawer in the kitchen. There was one thing I found exceptionally helpful on those little units, though –  the sleep function.

Now, I am sure any sleep specialist would admonish that these trackers are not all that accurate for sleep analysis, but waking up in the morning and seeing how many “wake ups” and “movements” you had on your little readout, to me, was fascinating.



Many things contribute to the quality of your sleep. Many have been discussed in previous posts on sleep. (See additional posts on sleep below.) But one of the factors that I think universally affects the quality of sleep is your sleep position. Now, as a chiropractor, I may be a little bias as to the importance of the position because sleep “posture” is my wheelhouse. But as I have sleep trained hundreds of patients to adjust their bodies to sleep in a more posturally conducive position they have reported not only sleeping better, but also that their back and neck pain, those headaches and many other complaints have disappeared.

That is all excellent. I am all for pain cessation and good quality sleep, but I am robustly passionate about you, my Poodle, having a vitally healthy spine and nervous system into your nineties. Poor sleep position will definitely foil my plan.

So it is of utmost importance that we cover the basics of proper sleep position. Read carefully. Some of this may surprise you!

We discussed a mattress selection in a previous post so we can move on knowing that you have an excellent mattress. See post here if you don’t.

There are two acceptable sleep positions for a healthy spine. In no particular order, they are one your back, or on your side. No, this post is not over, far from it. Each of these positions has many criteria to adhere to if you are going to do it right.


[Tweet “Get off your stomach!”]

 ON YOUR BACK: When you are on your back, you will want to have a pillow under knees. This keeps the knees from hyperextending and helps the hip flexors and hamstrings remain in a relaxed state. These muscles need to be relaxed because if those muscles stay tight over the course of the night, you may wake up to a lovely bout of back pain. By the way, pain upon rising in the morning is not normal. It is common, but not normal. You should wake rested and pain-free. In this position, your head should be well supported but not flexed up. Think about the curve of your neck getting the support it needs but not so much support that the head is flexed forward. The need for proper neck positioning is why contour pillows are so popular!

ON YOUR SIDE: Lying on your side to sleep is perfectly acceptable. However, there are some serious rules and regulations if this is your position of choice. Let’s start at the top. If you have a proclivity toward side sleeping, then you better have a pillow that supports your head in a side sleeping position. This means your head should remain in neutral not crunched over to the downside shoulder or lifted too high flexing toward the up-side shoulder.

Next, it is best if you hug a pillow to your chest to prevent your shoulders from collapsing inward. At the minimum, inwardly collapsed shoulders are going to exacerbate crappy posture, at worse this position will cause or exacerbate shoulder impingement issues. The other thing that hugging a pillow to your chest does is prevents your elbows and wrists from hyper-flexing (more impingement), and it also inhibits those of you who have a tendency toward shoving one hand up under the pillow. (A sure sign your pillow is not the right level of support, by the way).

Finally, you should have a pillow between your knees that extend to your ankles. Seriously?? Yes, seriously. This recommendation is not just for pregnant women. Here is the why. In many people, particularly women, the hips are wider than the knees. So when you are on your side, that imbalance causes undue rotation in the spine, and wear and tear on the spine and hips. If you separate the knees and ankles to match the width of the hips pressure is relieved from the lower spine, the hips, and the IT Bands thus providing a more physically positive sleep position.

When my husband I got married I taught him how to sleep in the side-lying position. He used to be a stomach sleeper. (More on that in a minute.) Once he got used to it (give it five nights) he could not sleep any other way. He sleeps more deeply and peacefully than before. My mother thinks it’s hysterical we take six pillows to bed with us! But, many of my patients have reported that this pillow placement in the side-lying position has cured years of hip and back problems.


 THE DREADED STOMACH SLEEPER: I am not going to sugar coat this. You have to get off your stomach. Why? Here are the three main reasons why it is one of the worst things you can do to your spine. When you sleep on your stomach, you put your lower spine into an arched position, which can cause shearing and irritation to the facet joints of the lower vertebra. I am not even acknowledging that a grand percentage of stomach sleepers jack one knee up into a bent position. Well, now you’ve gone and rotated your hips out of alignment! This “hip twisty” can also add to a back problem.

When you sleep on your stomach, you disallow the main “inspiratory” muscles to function properly. Put more simply it means you can’t breathe. At least not as well as if you allowed the front of your chest, ribs, and associated muscles to move freely.

Finally, you can’t sleep on your stomach because when you do you have to rotate your head one direction or another. This hyper-rotation causes compression of the nerves exiting the neck and can create long-term neck imbalance, dysfunction, and pain. We also tend to rotate our head more comfortably one-way versus the other. So not only are you slowly destroying the nerves of your neck, you are creating a gross cervical imbalance by going to one particular side so dominantly. SO, if a jacked up low back, asphyxiation or cervical nerve severing aren’t enough to convince you to get off your stomach I might be at a loss. I believe so strongly in the detrimental effects of stomach sleeping that I have duct taped tennis balls to patients’ nightshirts to force the issue.


Now you know the sleep positioning that is the most conducive to a peaceful night sleep I will leave you with a challenge. Try sleeping in one of the two positions suggested for five nights. Feel free to move from one to the other but try to stick to those two primary postures. Then, in the morning, see how your body feels. Did you sleep better? Are you in less pain? I would love to hear how it went!


Want to just watch the FACEBOOK LIVE BROADCAST of this post? 

















43 Responses

  1. I was totally a stomach sleeper until I got pregnant and couldn’t be. I still fall that way occasionally, but I am going to be much more aware of it now!

  2. Great post. I am not only a stomach sleeper (well used to be) I am also a side sleeper that has caused severe long lasting impingement of my arteries in my shoulder from bad posture! It really is worth altering your position for life so as not to get injured. x

    1. I know, it is crazy Chloe. If we all did physical labor all day and were super strong, how we sleep might not have such an impact but unfortunately, it does and we have to pay attention to that. Sleep well my friend!

  3. Hi Heather… sleep… OMG… I had to go buy a body pillow and two pillows for my back. I am 5 months pregnant and sleeping is even more uncomfortable. Since I purchased more pillows I am resting much better than before. 🙂

    1. Good! Tape tennis balls to the front of his nightshirt if he doesn’t comply with the recommendations! 🙂

    1. I find many of my stomach sleepers do great once they start hugging a big pillow. Good luck to you,Chanel!

  4. The timing of your post is amazing! I just left the chiropractor and have been having so much trouble with my neck, back and some headaches. I’m going to try a different sleeping position…you have me convinced! It’s easier said than done, I’m grateful for your awesome recommendations!

    1. I am so glad you find this information helpful, Jessica. Please let me know how the recommendations are useful to you! Good for you for connecting with a good chiropractor. 🙂

  5. I used to sleep on my stomach until I became a breastfeeding mom. I guess it’s a good thing I don’t sleep that way now that I’m reading your post. I now sleep on my side curled up in a ball. Is that bad?

    1. Angela, as long as you are adhering to proper pillow placement at the chest and between the legs you should be in good shape. Curled up in a ball with no pillow placement can cause issues over time. Make sure to have great head support as well!

  6. I need to add a pillow for support when sleeping on my back. The problem is that I switch positions constantly during the night. Thankfully doing yoga helps me with any back and neck problems.

  7. Stomach sleeper here! This is super interesting, but I have zero intentions of making any changes simply because it is the ONLY way for me to fall asleep. I grew up as a side sleeper, but have converted to a stomach sleeper these last couple years. I have a mild form of Tourette’s and my stomach is the most affected by it. Laying on my stomach is the only way to “calm” it and allow me to be still long enough to fall asleep. Otherwise, I will toss and turn all night because my stomach will be nonstop moving. I don’t have any medical problems related to how I sleep so I’ll take my chances.

    xo, Keating | Why Hello Lovely

    1. Two things I might recommend, Keating. Make sure you are alternating which way your head is turned. Also, I have had patients in your situation and a firm pillow hugged to the stomach to apply that needed pressure (but in the side-lying position) has worked wonders. Also, you may not have problems now but like carpel tunnel in people who type for years and years with no issues, the problems I am talking about come up over time. You may be pain-free now but your seventy-year-old self may suggest otherwise. Good luck to you! 🙂

  8. Thanks! Just ordered my back to side pillow. Can’t wait to feel the difference. I will also look for a good body pillow but hate waking up to move it everytime I change position.

    1. That makes me think. I should add a good body pillow to the list in the blog. Thanks, Allison!

    1. Me too. It is like a little hobby for me! How can I make it better and better. it is like a secret to better health, that is for sure.

  9. I am a side sleeper with a small pillow between my knees, and a bear hugged to my chest. I don’t sleep particularly well and have on going trouble with my back and shoulders.

    Tonight I am trying the 3 pillow hug and grasp method!!
    Perhaps I should ask for a bigger bear for Christmas?

    1. Ha ha! Yes a bigger teddy for Christmas would be in order otherwise I think you are doing a great job!

    1. That is great April! I hope you get better sleep now that you know the best positions to be in!

  10. This is so great! Thank you! I am a side sleeper and put up with flat pillows for way too long until I finally replaced them with ones that now feel too big! I’ll pay more attention in the pillow aisle now!

    1. Good work. It is a hard job finding the right fit! Very important though. We need to spend a little money on quality pillow products! 🙂

  11. This was an interesting read. I am a stomach and side sleeper, I have never been able to sleep on my back. I am limited in side sleeping as I can’t lay on my right side for a long time since I was in a car accident a few years ago, and weight on that shoulder causes tightness and pain later on. I had to sleep on my back for almost a year after that and I dozed, I never slept, and that has continued, so any advice you have for me now I would be grateful!

    1. The side sleeping is perfect. Can you work with some of the pillow placement recommendations to make it more comfortable? The proper neck pillow will make a big difference on how your shoulders react. What kind of mattress are you using? If you cannot break yourself of the stomach habit try to reduce the percent of the time you are there. Also, alternate which side your head rotates to. Let me know if I can be of more detailed help to you.

  12. Wow, wow, wow! Thank you so much for all this information. I never knew! I am a back sleeper, but my husband is a stomach sleeper….it stops him from snoring…any suggestions for this??

    1. Breath-rite strips work for about 65% percent of the snorers out there. Also, the bigger question is why is he snoring? Weight? Food Allergies? Bad pillow? There are also great essential oils for snoring. I would love to consult with you on all these options if you would ever like. Just message me!

    1. I am so glad that you enjoyed. Sleep is my new jam. I can’t wait to release my book on it early in the new year!

  13. I’m all over the place when it comes to sleep position. Trying so hard to be a back sleeper, but was a stomach sleeper for so long, I tend to flip back. Biggest correction I’m trying to make now is overcoming the habit to sleep with arms above my head to save my shoulders. Any chance you have illustrations to show how these positions/pillow arrangements look? Thanks Heather.

    1. Susan! What a great question. I am doing a demo this Friday on Facebook live. I will email it to you when I am done or you can check it out on the welLFITandFED page on Friday!

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About Dr. Denniston

Dr. Denniston is a wellness strategist for elite leaders and their teams, bridging the connection between personal well-being and professional success. She provides custom solutions for burnout and stress and facilitates cohesive habit-training strategies that maximize vitality, productivity, and resilience.

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