Rebecca Nicholas, Doctor of Chiropractic and owner of Back 2 Balance, likes nothing better than to encourage clients to choose healthier options and make lifestyle corrections for the long term benefit of a vibrant full life. In this blog, she answers one of the most popular questions that chiropractors and osteopaths get asked……what is the best sleep position?


If you’ve ever woken up with a stiff neck, you understand the short-term impact of a poor sleep position. Symptoms, which are typically caused by muscles straining and joints jamming in response to an awkward neck/back position, include pain and discomfort that is often intense and can linger for days. It’s your body’s way of telling you something was not right.

Neck pain, low back pain, headaches, muscle and joint problems may all be caused or worsened by an inappropriate sleep position or even sleeping in the same position all of the time, and a good indicator that you should reconsider how you are sleeping.

The good news? If you believe that your sleep position is causing you problems, the fix is free. You simply need to adjust your habits over time.

Considering that we spend, on average, 1/3 of our lives in bed, it makes sense to ensure that we’re not sleeping in a way that contributes to our back and neck problems.


Back sleeper?

There are various sleeping positions that can provide better overall alignment for your spine which decreases the chances of waking up to pain in the morning. A general rule to follow is you want your spine in a neutral position. To achieve this, the best position for sleeping is on your back. Sleeping on your back allows your head, neck and spine to maintain a neutral position.

While sleeping on your back, you should place a pillow under your knees or a rolled towel under the small curvature of your lower back to maintain the spine’s general curve. The height of the pillow should be equivalent to about the width of two fists. By placing a pillow under one’s knees while back sleeping, the low back spinal joints are flexed just slightly, which prevents any jamming of these joints throughout the night.

The bad: The main drawback is a greater chance you will snore, which can lead to more serious health issues, especially if you have sleep apnea.

Tip: For optimal structural health benefits when sleeping on your back, consider setting your pillow aside or using a cervical roll (a small cylindrical pillow) that provides support for your neck without elevating your head. When sleeping on your back, your face should be parallel to the ceiling, not tilted up or down.

Side sleeper?

Sleeping on your side is another good sleep position, which complements the natural curvature of the spine while keeping the spine elongated. As it turns out, sleeping on your side is the most popular sleeping position. According to a nationwide survey of more than 2,000 people by Tempur-pedic, 57% of people start in this position.

While sleeping in the side position, it is ideal to keep your knees slightly bent and a pillow between your legs.It is not good to sleep with one leg elevated higher than the other. This can put too much pressure on your hips. 

In addition, if you have shoulder pain, be sure to avoid sleep on the side with the painful shoulder, as this this will aggravate the injured area. Keeping your arms in front of you and not under your head or pillow will prevent your hands from going numb from nerve irritation and reduce the stress on your neck and shoulder. 

The bad: Nerve compression and muscle tightness in your shoulders and neck are two possible musculoskeletal problems associated with side sleeping.

Tip: Use a pillow that holds your neck in a neutral, aligned position. The pillow should be the thickness of your shoulder and should hold your head in such as way that it is neither elevated or depressed compared to your spine. Also consider placing a second pillow between your knees in order to keep your hips open (roughly the width of a fist- this will serve to keep the pelvis neutral minimising compression or twisting forces on the sacroiliac joints). This tip is particularly beneficial for pregnant women. Side sleeping, especially sleeping on your left side, is the recommended sleeping position for pregnant women.

Stomach sleeper?

Laying on your stomach is the worst sleeping position for your back and neck. Sleeping on your stomach creates the most strain and pressure against curvature of your neck and lower back. As it flattens the natural curve of the spine, lower back pain can result.

First, if you’re a stomach sleeper, you need to do all you can to try and break the habit. Not only does this position put your low back in an awkward position of hyper-extension, but it also forces the neck into rotation throughout the night, which is extremely unhealthy for both regions of the spine.

There are some thoughts from the psychology community that stomach sleeping may have an emotional component. Stomach sleepers often find it difficult to fully relax enough to fall asleep whether on their back or sides.

The bad: It may negatively affect your neck by stressing joints and muscles, and contributing to numbness, tingling, and pain in your extremities.

Tip: If you prefer sleeping on your stomach, try to shift positions several times in the night and gradually reduce the amount of time you spend on your stomach (ideally until you avoid the position altogether).For stomach sleepers I recommend using a pillow against the chest region to recreate the compression they enjoy while sleeping on their stomachs.

So, in short, back and side sleeping are best especially when the correct head pillow, mattress and knee pillow are utilised to promote a neutral and ultimately healthy spine.

In summery:-

  • Skip Sleeping on Your Stomach
  • Use a Pillow In Between Your Legs
  • Use a Pillow Underneath Your Legs for Back Sleepers

Good sleep is important for better health. Make sure you are drifting off to sleep in the best sleep positions for your body. Still feeling stiff in the morning? A chiropractor might help. Manual adjustments can help fix any joint or muscle imbalances and therefore, help you to achieve better sleep posture at night. An added bonus is that regular chiropractic care may make it easier to fall asleep at night.

I’m interested to know- what position do you sleep in? Do you experience discomfort in your back, neck or hands? Any tips we’ve missed pleased add them below, we would love to hear from you.