Patients often ask what position is best for sleeping. There are several general recommendations for a healthful night’s sleep.The most important rule is to never sleep on your stomach. Stomach sleeping puts a tremendous amount of stress on all of the components of your neck: vertebrae (bones of the spine), muscles, nerves, and other soft tissue. When a person lies on his stomach with his head turned sharply to the side to breathe, a vertebrae can often become subluxated (misaligned) in that rotated position. The constant rotation of the neck often results in nerve compression and stress to the joints in the spine. Stomach sleeping is a major cause of acute torticollis (stiff neck), headaches and dizziness. The previously mentioned symptoms may occur upon awakening, or they may occur gradually because of the constant stress to the neck.Stomach sleeping also puts your lower back at risk. Lying on your stomach exaggerates the curve in your lower back, never giving the lower back musculature a chance to relax. So, even though you may feel like you’ve rested, your lower back has been continually working. That can set you up for lower back problems that may come on, seemingly without reason.It is also important to sleep with the right kind of pillow.If sleeping on your side, you should lay with your knees slightly bent. You can put a pillow between your knees to separate them and put less stress on your lower back. Pull your pillow down so it is against your shoulder to support the neck and head. Avoid tucking your chin to your chest as this puts more stress on the musculature of the neck. When lying on your side, your head and neck should remain level with your mid and lower spine.For back sleeping, you can place one or two pillows under your knees to reduce stress to the lower back, neck and mid-back. To support your neck, the pillow should be pulled down to just under the shoulders. In order to support the head, the pillow must accept the weight of the head. When lying on your back, your head and neck should remain level with your upper back and spine. Avoid pillows that are so thick or thin that they angle your head and neck away from your body.The following pillows are not recommended:
- Foam rubber – the density of this material may keep the head flexed slightly forward. This is not a favorable position.
- Feather pillows – no matter how much it is fluffed up, it will tend to go flat and not support your neck.
- Two pillows – while you may position these pillows for good support of your upper back and neck but as you sleep, you will slide down on the pillows which will cause your neck and head to flex forward.
- Using a cervical/contour pillow if you sleep on your side – these pillows are designed to support the natural curve of your neck when you sleep on your back. If you use this while sleeping on your side, it will put excessive stress on your neck.
