The Best and Worst Sleep Positions for Health Conditions

It may seem to occur without thought, but have you ever wondered, “What position should I sleep in?” Body position can have an important impact on sleep. It may affect breathing and cause snoring or sleep apnea, worsen pain, or lead to insomnia. What are the best and worst sleep positions? How should you sleep to relieve back or neck pain? Consider the most common sleep positions and which might be best for various health conditions, including pregnancy.

1
Supine (Back)

man sleeping on back
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Description: Supine sleep occurs when a person is lying flat on his or her back. Legs are usually extended out in a neutral position. Arms may lie flat by the sides of the body. They may also be bent with the hands across the torso. Arms may also be raised above the shoulders with the hands placed by the face, above or behind the head, or outstretched to the sides.

Pros: If you can breathe well during sleep, this may be the best sleep position. The body may be more fully supported by the mattress and pillow. With a supportive pillow or cushion placed at the knees, this may reduce pressure and musculoskeletal pain. Supine sleep may be helpful if you experience chronic back, neck, shoulder, hip, or sciatica pain. With the feet raised above the heart, this may relieve peripheral edema (swelling of the feet and ankles) and reduce the impacts of congestive heart failure. This is also the preferred sleeping position for infants to reduce the risk of sudden infant death syndrome (SIDS).

Cons: For many people, supine sleep is best. However, those with trouble breathing during sleep may find that lying on the back makes this worse. This may manifest as louder snoring. Nasal obstruction and mouth breathing may also allow the lower jaw and tongue to more easily shift back and obstruct the airway. This may lead to the symptoms and consequences of sleep apnea. The following conditions may be worsened as a result of sleep apnea associated with supine sleep:

  • Sleepiness/Fatigue
  • Insomnia (Especially frequent awakenings)
  • Snoring
  • Dry mouth
  • Urination at night (Nocturia)
  • Teeth grinding or clenching (Bruxism)
  • Short-term memory loss
  • ADD/ADHD
  • Mood disorders (Anxiety or Depression)
  • Hearing loss
  • Glaucoma
  • Chronic sinusitis/Post-nasal drip
  • Heartburn/GERD
  • Palpitations
  • Atrial fibrillation
  • Hypertension
  • Hyperlipidemia
  • Diabetes
  • Heart attack risk
  • Heart failure risk
  • Stroke risk

2
Left Side

A woman sleeps on her left side
Adam Kuylenstierna / EyeEm/Getty Images

Description: Also known as the lateral position, the body is positioned with the head and torso lying on the left side. The arm may be under the body or may be slightly forward or extended, with some pressure at the left shoulder. The legs may be stacked, with the left leg underneath or slightly staggered. In a fetal position, the legs are bent and the knees are drawn toward the upper body.

Pros: This position avoids the adverse impacts of supine sleep and may be especially important to remedy position-dependent snoring and sleep apnea. Breathing may be optimal by sleeping on the left side. Pregnant women may place a pillow under their stomach or between their knees and find this position relieves pressure on the bladder and back pain. If a right-sided joint (often shoulder or hip) is causing pain, it may be eased in this position. Sleeping on the side can also facilitate spooning (lying closely side by side) with a bed partner.

Cons: Unfortunately, the left lateral position is not for everyone. When sleeping on the left, the internal organs in the thorax can shift. The lungs may weigh heavily on the heart. This increased pressure may impact the heart’s function, potentially worsening heart strain in heart failure. The heart may respond to the increased pressure by activating the kidneys, increasing urination at night. Pressure on the nerves within the left arm or leg may cause other problems. Chronic lateral sleep may contribute to shoulder, lower back (due to a shift in the curvature of the spine), and hip pain.

3
Right Side

A man sleeps on his right side
MAURO FERMARIELLO/SCIENCE PHOTO LIBRARY/Getty Images

Description: In this lateral position, the body is positioned with the head and torso lying on the right side. As before, the arm may be under the body or may be slightly forward or extended, with some pressure at the right shoulder. The legs may be stacked, with the right leg underneath, or slightly staggered. In a fetal position the legs are bent and the knees are drawn toward the upper body.

Pros: As with left lateral sleep, sleeping on the right side avoids the adverse impacts of supine sleep. If a left-sided joint (often shoulder or hip) is causing pain, it may be eased in this position. The right side also provides the opportunity for bed partners to spoon, if they are facing to their right.

Cons: With gravity shifting the internal organs to the right, the heart will shift the mediastinum towards the right lung. This will reduce the volume of the lung, and this may be important in certain pulmonary conditions. The decreased volume may compromise blood oxygen levels and strain the cardiovascular system in people with related health conditions. Pressure on the nerves of the right arm or leg may lead to compression injuries or neuropathy. As with left lateral sleep, sleeping on the right side chronically may cause right shoulder, lower back, and right hip pain.

4
Prone (Stomach)

man sleeping on stomach
laflor/istock

Description: Lying on one’s stomach is the least common sleep position. The face is typically turned to one side or the other to facilitate breathing. The arms and hands may be tucked underneath, positioned at one’s side, or extended outwards to the sides. The legs are usually extended and not bent.

Pros: As with lateral sleep, prone positioning can help to avoid the adverse consequences of supine sleep. It also prevents the organ shifts that occur with the thorax. If the surface being slept on is not particularly comfortable, lying on the softer part of the body (particularly the chest and stomach) may be preferred. Tucking arms close to the body can provide psychological comfort and conserve heat. Prone sleep may also be preferred to alleviate chronic musculoskeletal pain.

Cons: This position may lead to neck pain. It may also strain the associated muscles of the shoulder or upper back. Pressure on the nerves within the arms or hands may cause problems. Breathing may be somewhat compromised due to the body’s weight reducing lung volumes by restricting movement of the rib cage and diaphragm.

5
Upright

Sleeping with the head upright may help with breathing in sleep
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Description: Finally, it is possible to sleep with the head raised with respect to the body. This may be achieved by sleeping in a recliner, for example. A sleeping wedge pillow may also raise the head during sleep. Adjustable beds, including specialized mattresses, may also be used to lift the head above the body during sleep. The degree of head elevation may vary, but most benefit from raising the head by 20 to 30 degrees.

Pros: Raising the head during sleep may reduce the collapse of the airway and this may diminish the risk of snoring and the problems associated with sleep apnea. If positioned properly, it may also be possible to relieve pain.

Cons: It is nearly impossible to change positions during sleep. It is difficult to sleep laterally with the head raised by sufficient degree at night. As a result, the benefits of sleeping on either the left or right side cannot be realized. It would also not be possible to sleep in a prone position. The cons of supine sleep may still be present, especially if mouth breathing occurs.

6
Other Considerations

Woman sitting in front of laptop, head back, eyes closed
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When considering the best position for sleep, it is important to acknowledge your own needs. Consider the role of pain, sleep-disordered breathing like snoring or sleep apnea, and the numerous medical conditions described. Beyond the position of the body, consider the optimal positioning of your head and neck: a slightly extended neck may improve breathing.

To sleep best, it might actually be important to allow some flexibility. It is normal to wake from sleep to change position. This occurs frequently and may go unremembered. It is possible to subconsciously become aware of discomfort and remedy this by moving in the night. Ideally, these movements will minimize long-term problems associated with improper sleep positions.

A Word From Verywell

If you struggle finding a comfortable position to sleep in at night, before getting a new mattress, consider speaking with a board-certified sleep physician. Restless sleep may be provoked by an untreated sleep disorder. Testing and treatment may provide you improved sleep, no matter how you find yourself sleeping.

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