The Best and Worst Sleep Positions for Health Conditions

On Your Back

When a person is lying flat on his or her back, it's called the supine position for sleeping. The legs are usually stretched out in a neutral pose.

Arms may lie flat by the sides of the body. They may be bent with the hands across the chest or stomach. Arms also may be raised above the shoulders with the hands by the face, above or behind the head, or out to the sides.

Pros

If you can breathe well during sleep, this may be the best sleep position. The body gets good support from the mattress. With a supportive pillow or cushion placed at the knees, this may reduce pressure on the back and any muscle or joint pain.

With the feet raised above the heart, this may relieve edema (swelling) of the feet and ankles, and reduce the impact of congestive heart failure. This is also the preferred sleeping position for infants to reduce the risk of sudden infant death syndrome (SIDS).

Cons

Those who have trouble breathing when they sleep may find that lying on the back makes this worse. It also may cause any snoring to be louder.

Nose blockages and mouth breathing may allow the lower jaw and tongue to more easily shift back and obstruct the airway. This may lead to sleep apnea, pauses in breathing while sleeping.

Many health issues can be made worse because of sleep apnea in this position. They include:

• Urination at night (nocturia)
• Teeth grinding or clenching (bruxism)
• Heartburn/gastroesophageal reflux disease (GERD)
• High blood pressure
• Diabetes
• Heart failure risk

Left Side

The person sleeps with the head and torso lying on the left side, also known as the lateral position. The arm may be under the body, or perhaps slightly forward or stretched out, with some pressure at the left shoulder.

The legs may be stacked, with the left leg below. In the curled-up fetal position, the legs are bent and the knees are drawn toward the upper body.

Pros

Most people sleeping in this position avoid the problems of supine sleep, and their breathing might be better. It's a good choice for limiting the effects of snoring and sleep apnea.

If a right shoulder or hip is causing pain, this position may feel better. Sleeping on the side can also make "spooning" (lying closely side by side) with a bed partner easier.

A person who is pregnant may place a pillow under their stomach or between their knees, and find this position eases back pain and any pressure on the bladder.

Cons

The left lateral position is not for everyone. When sleeping on the left, the organs in the chest can shift with gravity. The lungs may weigh heavily on the heart.

This increased pressure may affect heart function, adding to the heart strain in heart failure. This may, in turn, mean that the kidneys increase output, causing more trips to get up and urinate during the night.

Pressure on the nerves in the left arm or leg may cause other problems. Sleeping in this position may contribute to shoulder, lower back, and hip pain in the long term.

Right Side

In this lateral position, a person sleeps with the head and torso lying on the right side. As before, the arm may be under the body, or maybe slightly forward or extended with some pressure at the right shoulder.

The legs may be stacked, this time with the right leg underneath, or with both knees pulled up toward the body in a fetal position.

Pros

As with left lateral sleep, sleeping on the right side avoids the problems of supine sleep. If a hip or other left-sided joint is causing pain, that pain may ease. It's also a way for bed partners to snuggle, this time facing the other way.

Cons

With gravity shifting the internal organs to the right, it's the right lung that may feel pressure. This will reduce the lung's ability to fill with air, and this lower volume may cause problems. The lower oxygen levels and the strain on the cardiovascular system can affect people with related health issues.

Pressure on the nerves of the right arm or leg may lead to compression injuries or neuropathy. As with left lateral sleep, long-term sleeping on the right side may cause shoulder, lower back, and right hip pain.

On Your Stomach

Lying on one’s stomach is the least common way to sleep. In this prone position, the face is typically turned to the side for easier breathing. The arms and hands may be tucked underneath, positioned at one’s side, or stretched out to the sides. The legs are usually held straight.

Pros

Sleeping on one's stomach can help a person avoid the problems of supine sleep. It also prevents the slight organ shifts in the chest.

There are comfort benefits too. If the mattress or other surface is not really ideal, then lying on the chest, stomach, and "softer" parts of the body may offset that.

Tucking arms close to the body can provide psychological comfort and conserve heat. Prone sleep may also be better for easing chronic muscle and joint pain.

Cons

Sleeping on your stomach may lead to neck pain. It may also place some strain on shoulder and upper back muscles. Pressure on nerves in the arms or hands may lead to problems.

It may be harder to breathe with the body’s weight pressing down on the lungs and limiting the motion of the rib cage and diaphragm, which sits just below the lungs.

Upright

Finally, it is possible to sleep with the head raised above the body. This can be done in a recliner, for example. A sleeping wedge pillow may also raise the head during sleep.

Adjustable beds, including specialized mattresses, can lift the head above the body during sleep. The degree of the angle may vary, but most people who need this will benefit from raising the head by 20 to 30 degrees.

Pros

Raising the head during sleep prevents 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. You can't sleep laterally very well with the head raised at an angle at night, and it's not possible to sleep in a prone position. Any problems with sleeping on your back may still happen, especially if mouth breathing occurs.

Other Considerations

When choosing the best position for sleep, begin by knowing your own needs. Consider the role of joint pain, sleep apnea, and any other conditions.

Be sure to think about your head and neck as much as the rest of your body. A slightly extended neck may improve breathing.

It is normal to wake from sleep to change position, even if you don't remember it. For the best sleep, allow some flexibility in your sleep positions.

It is possible to be aware of discomfort in your sleep and fix it by moving in the night. Ideally, this will limit any long-term problems caused by a particular sleep position.

Summary

Getting a good night's rest is important to health and well-being, and it's far too often overlooked. Sleep can be even more of a challenge if you have joint pain, breathing, or other problems. It may help to try a new way of sleeping.

A Word From Verywell

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