Sleep Positions: Impact on Health and Well-being

In this article we go through sleep positions from a psychological perspective, different sleeping positions from various viewpoints, and the harm of sleeping on the stomach and solutions.

To sleep well and stay healthy, people generally need about eight hours of sleep each night, which is roughly a third of a day. But did you know that how you sleep, not just how long, can really impact your health?

Waking up with aches and pains isn't unusual. For some, it's because of an injury or ongoing health issues. For others, it might be all about their sleep position, especially for stomach sleepers.

Sleep Positions from a Psychological Perspective

According to Professor Chris Idzikowski, director of the Sleep Assessment and Advisory Service, he analyzed six common sleeping positions of a 1000 people and found that each one is linked to a particular personality type.

1. Foetus

Easily the most popular sleeping position, in fact, 41% of the 1000 people surveyed during Professor Idzikowski’s study stated it was their preferred sleeping position and more than twice as many women than men tend to adopt this position.

These people are extroverted and sensitive at the same time. They may be shy, but they quickly become intimate and friendly. 

2. Log

Those who sleep on their side, with their arms and legs outstretched, typically exhibit sociable personalities. They are generally easygoing, quick to trust others, and at times may even be perceived as gullible. This sleeping position accounts for approximately 15% of the population. 

3. Yearner

The yearner is sleeping on your side like the log except your arms are reaching out in front of you, as if you were “yearning” for something or someone. This sleeping position is observed in approximately 13% of the population. Those who adopt this position tend to be intellectually curious and open-minded, yet they also possess a cautious and discerning nature. Once they make a decision, they are steadfast and unwavering in their pursuit of it.

4. Soldier

The soldier or back sleep is a person that sleeps on their back, with their arms straight down at their side — like they are standing at attention. This sleeping position is favored by almost 8% of the population. Those who adopt this position tend to be calm and composed, preferring to avoid noisy environments and consistently aiming to uphold high standards for themselves and others. However, it is worth noting that they are also more prone to snoring while sleeping.

5. Freefall

Lying on your front with your hands around the pillow, and your head turned to one side. The second least common sleeping position, Professor Idzikowski noted, people who prefer this sleeping position are often gregarious and brash but can be nervy and thin-skinned underneath. They often don’t like criticism, or extreme situations, they’re less gullible and take their time to make up their mind.

7% of people adopt this position while sleeping.

6. Starfish

The least common sleeping position, the starfish is lying on your back with both arms up around the pillow. 5 % of the population favored this position. People who sleep like this may have an unconventional style but are very loyal friends and make relationships a great priority. They love to be supportive, acting as a sounding board for their friends’ problems, and will go out of their way to help others.

• In relation to health, Professor Idzikowski concluded that the freefall position was good for digestion, while the starfish and soldier positions were more likely to lead to snoring and a bad night’s sleep.
• Professor Idzikowski said: “Lying down flat means that stomach contents can more readily be worked back up into the mouth, while those who lie on their back may end up snoring and breathing less well during the night. Both these postures may not necessarily awaken the sleeper but could cause a less refreshing night’s sleep.”

• The research also found that most people are unlikely to change their sleeping position, with just 5% said they sleep in a different position every night.
• And a surprising number of sleepers stick a limb out of their duvet, while only 1 in 10 slept entirely covered. 

 

Different Sleeping Positions and Their Effects on Your Health

We need to realize that our body is resting during sleep. If we don't sleep correctly, we can seriously damage our body. This damages the body's ability to recover and rebuild, which is its main job while we're asleep. Whether you sleep on your back, stomach, side, or in a fetal position, it impacts how you breathe, your spine's health, and blood flow.

• Beneficial for the back and face

Also known as the “starfish”, this sleeping position is good for your back and is also said to prevent facial wrinkles and skin breakouts. However, similar to the arms-down back-sleeping position, it also can cause snoring and problems with acid reflux.

Generally, back sleeping can reduce acid reflux and, in women, may decrease the likelihood of breast sagging with age.

However, the starfish position can increase the risk of sleep apnea and snoring. Another downside is the potential strain on shoulder tendons and reduced local blood circulation, often leading to tendonitis.

2. On Your Back with Arms by Your Side

• Beneficial for the neck

Sleeping on your back with your arms by your side, also called soldier, is considered the best sleeping position for health. This sleeping method is good for the spine and neck. However, be careful not to use very high and unsuitable pillows. The only drawback of this sleeping position is its impact on breathing. People who sleep this way tend to snore more than others. In fact, sleeping on your back can cause blockage of the respiratory tract, which is known as "sleep apnea."

Overall, sleeping on your back can help alleviate back pain and reduce facial wrinkles. However, this position can also increase the risk of snoring and sleep apnea, as it easily allows your tongue to restrict your throat.

3. Sleeping on Your Back (supine)

Sleeping in supine position with hands under your head, is another incorrect way of sleeping. This position can cause your shoulder and neck muscles to be under strain, leading to pain and stiffness in these areas when you wake up. If you sleep in this position, it's recommended to place a small pillow under your knees to support the natural curve of your spine and ensure that the pillow under your head is suitable so that it doesn't leave a gap in the lower back area. This can help reduce the potential discomfort associated with this sleeping position.

4. Fetal Position

• This position can cause back and neck pain

Sleeping in the fetal position, curled up into a ball with your knees drawn into your chest and your chin tilted downwards may be comfortable, but it can strain your neck and back.

The extreme curl of this position can also restrict deep breathing. However, this fetal position may be the best sleeping posture if you are pregnant or experiencing problems with snoring.

5. On Your Side with Arms by Your Sides

• Watch Out for Wrinkles: This Sleeping Position Can Cause Them

Specialists believe that sleeping on your side is beneficial for the spine. Sleeping on your side and placing your hands in line with your body, known as the log position, helps maintain the spine in its natural alignment. This, in turn, reduces lower back and neck pain.

According to experts, sleeping on the side and using a small pillow between the knees can reduce excessive pressure on the lumbar spine vertebrae, as well as on the muscles and nerve fibers connected to the spinal column. Side sleeping decreases Gastroesophageal reflux disease (GERD) (occurs when stomach acid repeatedly flows back into the tube connecting your mouth and stomach (esophagus)), reduces snoring, and is suitable for sleeping during pregnancy. This sleeping position also helps in preventing sleep apnea.

The main issue with sleeping on your side is its impact on the skin. Individuals who regularly sleep in this position are more prone to wrinkles and fine lines, as the skin is in contact and rubs against the pillow and mattress. Additionally, there is a higher likelihood of breast sagging in women who sleep in these conditions.

6. On Your Side with Arms Out

• There is a likelihood of experiencing lower back pain.

This position, also known as yearner position, has many of the same benefits as sleeping on your side with your arms positioned straight down. However, side-sleeping can cause shoulder and arm discomfort due to restricted blood flow and pressure on the nerves, which may be exacerbated by having your arms out in front of you.

7. With Pillow Support

• Beneficial for the Spine

Nevertheless, each of us has our own specific habits, and sleeping positions are no exception. Try to adjust your sleeping posture as much as possible, but in any case, using multiple pillows is the best approach for a more comfortable sleep.

Back sleepers can place a small pillow under their lower back. Placing another small pillow under the thighs provides additional support to their joints.

For those who sleep on their side, placing a small pillow between their knees is recommended.

It's recommended to use pillows with natural fibers for your head. The right pillow reduces pressure on the neck vertebrae and upper spine, maintains the natural curvature of the spine, ensures proper head position relative to the body, and minimizes spinal strain.

 8. On Your Right or Left Side

• Your shoulder and leg hurt worse.

If you sleep on your side, you need to be mindful of whether you're sleeping on your left or right side. Sleeping on the right side can increase heartburn, while sleeping on the left side strains internal organs such as the liver, lungs, and stomach. Doctors recommend pregnant women sleep on their left side, but it's better not to consistently sleep on one side. Prolonged side sleeping can put excessive pressure on the shoulders and legs.

Research conducted at the University of California suggests that individuals who consistently sleep on one side are more prone to kidney stones. Studies on 93 patients with kidney stones showed that 79% of them had stones on the side they slept on.

Sleeping on your side with your upper leg bent and your lower back twisted toward the ground is very dangerous. This position stresses and strains the muscles and joints of your back and neck, leading to deformity and discomfort in the long run.

When sleeping on your side, choose an appropriate pillow for under your head and place a small pillow between your knees.

If snoring or sleep apnea is a concern, side sleeping may be a better position for you. It's worth noting that sleeping on your stomach can also reduce the risk of snoring and sleep apnea as this sleep position naturally keeps your airway open, but it has many side effects. However, side sleeping has a similar protective effect and has more benefits than sleeping on the stomach. For example, sleeping on your side can help alleviate heartburn, snoring, and lower back pain. Side sleeping is popular, with over 60% of people using it.

 

9. On Your Stomach (prone)

• Take care of your neck

Most of us are aware that sleeping on the stomach is the most damaging sleep position. It harms your health. One of the improper habits people have while resting is sleeping on their stomach. While this position can reduce snoring and eliminate sleep apnea, it puts excessive pressure on the back and neck. Try never to sleep in this position. Sleeping this way can lead to back and neck pain and facial wrinkles.

Sleeping on the stomach in women can lead to sagging of the breast skin, and in the long term, it may cause joint pain. The only advantage of this sleeping position is a reduced likelihood of night snoring. Certainly, when a person sleeps on their stomach and tucks their head into the pillow, they cannot breathe properly. Therefore, the person should position their head in a way that allows for proper breathing; however, this adjustment can lead to neck, head, and shoulder pain. Sleeping on the stomach can also result in bruxism (teeth grinding) and pain in the facial jaw area or headaches.

In this position, the Earth's gravity contributes to the sagging of our skin, especially facial skin, and our abdomen appears larger. Researchers have derived these observations after studying the skin and bodies of individuals who habitually slept on their stomachs throughout their lives.

Prone sleeping, whether with arms positioned upwards, downwards, or without a pillow, can cause problems. It is said that one third of back issues are related to stomach sleeping. It causes your muscles to be positioned in a way that they cannot fully relax, and your joints are under strain. They cannot release themselves while you are asleep. This ultimately leads to a feeling of tiredness in the morning and a significant loss of energy during night sleep.

According to a study by the Mayo Clinic, sleeping on the stomach not only puts pressure on the back but also damages the spine, as the midsection is where most of the body's weight is concentrated. The pressure on the spine then affects the rest of the body's structure. Additionally, when people sleep on their stomach, they have to turn their head to one side to breathe, causing the head and spine to misalign.

 

When sleeping on the stomach, several problems and complications can arise. Although some people might find it comfortable, it's generally not recommended. Here are some common issues associated with sleeping on the stomach:

Consequences of Sleeping on the Stomach

The spine may not maintain its natural curve, leading to misalignment. The optimal sleeping position is one that supports a healthy spinal alignment. When you sleep on your stomach, your upper body tends to sink deeper into the mattress due to its weight. As a result, your back might arch, taking your spine out of its neutral position. When your spine isn't aligned, you experience stress and pressure, which can lead to pain and fatigue upon waking.

According to Mayo Clinic research, this sleeping position can damage the back and spine. The main reason is that most of the body's weight is concentrated on the middle part of the body. Pressure on the spine can harm other body structures, leading to tingling and numbness, making you constantly feel like some parts of your body have fallen asleep.

2. Neck Strain

To breathe, you must turn your head to one side, which can strain the neck. As you sleep on your stomach, the abdominal muscles gradually weaken, the back becomes hunched, the neck is damaged, and the person feels cramps and contractions. When you sleep on your stomach, you need to turn your head to one side to breathe, requiring you to twist your neck, causing it to misalign with the rest of your spine. In addition to back and neck pain, poor sleeping posture can lead to other complications such as headaches and shoulder or arm pain. Many people who habitually sleep on their stomach experience pain in the neck, back, and joints. This pain can affect your sleep quality and cause you to wake up several times at night due to the intensity of the pain.

Overall, sleeping on the stomach puts pressure on the neck and back areas. Over time, this can lead to neck pain, shoulder pain, and anatomical problems in the related areas. This issue can be severe enough to cause cervical disc problems and irritate your nerves.

3. Back Pain

Sleeping on the stomach may cause discomfort in the back and lower back areas, as it leads to increased pressure and tension in these regions. This can exacerbate problems related to upper and lower back injuries.

 

4. Increased Stomach Acid and Digestive Problems

If you're someone who sleeps on your stomach, you might be familiar with the discomfort and stomach pain associated with this sleeping position. Studies have shown that sleeping on the stomach can increase stomach acid, which in turn can cause numerous problems in your digestive system. Individuals with stomach reflux are advised to sleep on their left side, as this position allows for better alignment of the airways.

5. Effects on the Respiratory System

Sleeping on your stomach can restrict airflow, potentially causing problems for some people, especially those with respiratory issues or who suffer from sleep apnea. Some studies have indicated that sleeping on the stomach may increase the risk of lung-related issues such as respiratory distress in infants or sudden infant death syndrome (SIDS).

6. Formation of Kidney Stones

Scientific research has shown that sleeping on the stomach is risky, and it's better to sleep on the right side. One of the major risks of sleeping on the stomach is the formation of kidney stones. Sleeping on the right or left side can prevent kidney stone formation, but sleeping on the stomach can cause the body to remain inactive, leading to stone deposition in the kidneys.

7. Facial Wrinkles

The face pressing against the pillow can contribute to wrinkles over time. When one side of your face is pressed against the pillow, your skin undergoes tension and compression throughout the night. Consequently, sleeping on your stomach may lead to facial wrinkles and lines.

Risks of sleeping on the stomach during pregnancy

If you sleep on your stomach during pregnancy, it can potentially harm the fetus, and over time, poor sleep quality may lead to insomnia. Insomnia during pregnancy can increase the risk of premature birth, longer and more painful labor, and postpartum depression. Instead of sleeping on your stomach, it is recommended for pregnant individuals to sleep on their left side. This position helps alleviate pressure on the liver and the vein that carries blood from the legs to the heart. It also improves blood flow to the fetus, uterus, and kidneys. Using a pregnancy pillow to support the abdomen and prevent leg crossing can make side sleeping more comfortable.

Sleeping on the stomach gradually weakens the abdominal muscles, can cause the back to arch, leads to neck injuries, and the person may feel cramping and constriction. While this risk may not be evident in the early months of pregnancy, it becomes significantly higher after the fourth month. Therefore, pregnant women should be more careful about their sleeping position and avoid sleeping on their stomach.

Sleeping on your stomach the worst sleeping position

If you sleep on your stomach and experience stiffness or pain, you might want to try a new sleeping position. Research indicates that sleeping on the stomach is the worst position for your back. Sleeping on your back or side significantly offers more health benefits than sleeping on the stomach. For instance, a study on people with back pain yielded interesting results. It found that those who switched to sleeping on their side or back reported less back pain.

Sleeping on the stomach is often considered unfavorable and is highly discouraged. There is a saying that if you see someone sleeping on their stomach, you should wake them up because this is the sleep of the devil.

• Given these disadvantages, it is recommended that if sleeping on your stomach is uncomfortable for you or leads to problems such as neck or back pain, you should change your sleeping position. Instead, try sleeping on your back or side.

Tips for Improving Stomach Sleeping

Some people, despite their efforts, cannot sleep on their back or side. Try these tips to minimize the side effects of sleeping on your stomach. Keep in mind that changing your sleeping position from stomach to back or side may require you to buy different pillows and even a different mattress.

According to Healthline website, if you are among those who cannot sleep in another position, you can use the following strategies to reduce the side effects of this sleeping position:

1. Use a very thin pillow for sleeping, or don't use a pillow at all.

When you sleep on your stomach, try to sleep with a very thin pillow under your head, or without a pillow at all. The thicker your pillow, the more pressure it puts on your neck. This is because a pillow forces your neck into an upward angle. When you sleep without a pillow, you place your head directly on the mattress surface. In this position, there is a possibility that your head and neck will align with your spine.

2. Place a small pillow under the pelvis

To align the spine, place a thin pillow under your pelvis. Additionally, position a pillow between your thighs. Placing a pillow between the thighs prevents the central part of your body from sinking into the mattress, relieving pressure on the spine.

When sleeping on your stomach, tilt your head to one side to allow for breathing. However, consistently tilting your head to one side for an extended period can cause damage to vulnerable vertebrae because the ligaments and muscles protecting the cervical spine are excessively stretched. Therefore, sleeping on the stomach is not an ideal choice for neck health. You can mitigate issues associated with this sleeping position by avoiding the use of a pillow.

3. Perform stretching exercises after waking up.

The healthy spine has natural curves and, when viewed from the side, exhibits an S-shape. Sleeping on your stomach puts these natural curves in the lower back under pressure. Excessive pressure and strain are placed on the ligaments that keep the spine in place. Sleeping on your stomach for just one night can cause back pain, and if this position is maintained for an extended period, it can lead to muscle stiffness on both sides of the spine. Muscle stiffness in the lower back also makes it difficult to engage abdominal muscles, potentially weakening the body's core strength. You can place a pillow under your pelvis to reduce pressure on the lower back. However, from my experience, since we move during sleep, this pillow can end up being more of a hindrance than a help.

Stretching Exercises

You might also have the habit of sleeping on your stomach and try your best to sleep in other positions, but unconsciously return to the position you are used to. In this case, we recommend that to prevent pain, you should do some stretching exercises on the bed every morning.

First, get on your hands and knees on the floor, keeping your back straight and engaging your abdominal muscles. As you inhale, let your stomach flatten, arch your back, and raise your head and lower back. While exhaling, curve your spine upwards, pull your abdominal muscles towards your spine. Pull your chin towards your chest and simultaneously draw your tailbone downwards. Breathe in this position for one minute, allowing your back to stretch in both states.

Another stretch you can perform involves kneeling on the floor with your knees spread as wide as your hips, and your big toes positioned directly behind you. Take a deep breath in, and as you exhale, lower your torso down onto your thighs. As you extend your chest away from your tailbone and your head away from your shoulders, try to elongate your neck and spine. Rest your arms alongside your legs with the palms facing up, or you can extend your arms forward on the floor. Stay in this position for the duration of five breaths or more, and when you're ready to rise, inhale as you lift your torso.

 

Additionally, to prevent reverting back to sleeping on your stomach, you can use other methods. Common techniques include using a large pillow under your chest and stomach, placing a pillow or soft items under your abdomen, or using small pillows to support the lower back area. These methods can help you maintain different sleeping positions other than on your stomach.

The perspective of Persian Traditional Medicine on sleeping on the stomach

It suggests that this position, in addition to digestive and respiratory side effects, can negatively impact the facial form and create unwanted lines on the skin. Scientific research has shown that sleeping on the stomach is very dangerous, and it is better for a person to sleep on their right side. Experts recommend avoiding sleeping on the stomach as it always causes extra pressure on the cervical vertebrae and often affects the lower back.

Ergonomics experts' view on sleeping on the stomach

According to ergonomic experts, sleeping on your stomach is harmful for your back because, when you lie on your stomach, it's practically impossible to keep your spine in a neutral and relaxed position. It offers very little support, creates tension, and leads to additional pressure on the neck. In many cases, people don't fully sleep on their stomach but rather in a half-stomach, half-side position. This somewhat distorted position can lead to complaints of neck pain and lower back pain.

Here are some suggestions for a healthy sleep routine

• Sleep facing the Qibla. It is advised that sleeping in the direction of the Kaaba aligns the body magnetically. It is believed that our iron levels are regulated, keeping our body healthy and reducing the risk of heart diseases. Otherwise, iron may deposit in the walls of blood vessels, leading to a decrease in the body's iron levels.
• Train yourself to sleep with your lips slightly open to allow vapors to exit during exhalation, preventing potential harm to the roots of your teeth and maintaining a healthy complexion.
• Consider using cotton in your ears, especially in cold environments or areas prone to insects, to ensure a comfortable and uninterrupted sleep.
• Before going to bed, make sure to use the restroom, as this can prevent lots of need for medications and treatments.
• Prior to sleep, practice good oral hygiene by brushing your teeth and apply kohl (Surma) for overall well-being.

These practices aim to promote a restful and healthy night's sleep.