Sleep Disorders Pros and Cons of Being a Side Sleeper By Shamard Charles, MD, MPH Shamard Charles, MD, MPH LinkedIn Twitter Shamard Charles, MD, is a physician-journalist and public health doctor who advances health policy through health communication and health promotion. Learn about our editorial process Published on March 11, 2022 Medically reviewed by Kashif J. Piracha, MD Medically reviewed by Kashif J. Piracha, MD LinkedIn Kashif J. Piracha, MD, is a board-certified physician with over 14 years of experience treating patients in acute care hospitals and rehabilitation facilities. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Benefits Side Sleepers Positions Which Side to Sleep On Signs You’re Not a Side Sleeper Best Sleep Systems Frequently Asked Questions About a third of your life is spent sleeping, so finding a comfortable position is a top priority. Most people go to sleep in the most comfortable position they can find, but promising research is showing that some positions may be better for you than others. The majority of people sleep on their side—an idea that has been corroborated by a number of sleep studies. In fact, researchers in the Danish Physical Activity Cohort with Objective Measurements (DPHACTO) study—one of the largest sleep studies conducted in the world—found that sleepers spent over half (54.1%) of total time in bed sleeping on their side. Side sleeping can cause or exacerbate shoulder and neck pain, and contribute to muscle imbalance. Therefore, side sleepers need to be aware of their neck and shoulder alignment to avoid waking up with body aches. This article explains how to get the most out of side-sleeping while avoiding serious injury. Getty Images Benefits of Being a Side Sleeper Pain Sleeping on your side is good for spine alignment. It may alleviate pressure on your back that can cause or exacerbate back pain. Sleeping with a pillow in between your knees has also been shown to be an effective way to treat hip and knee issues. Digestion While there's no empirical evidence that supports the idea that sleeping on one side or the other is more effective in aiding digestion, there is enough research supporting left-sided sleeping as a digestive aid that it can’t be ruled out. Still, most evidence is anecdotal, and more research needs to be done. Why You’re Waking Up With Heartburn Brain Health Early research points to side sleeping as a potential way to improve brain functioning and achieve optimal brain functioning. Preliminary research, primarily in animals, shows that side sleeping may aid in the removal of toxins from the brain and may even reduce the risk of neurological disease. Brain waste leaves through the glymphatic system. Cleansing of the glymphatic system occurs when you're sleeping. Side sleeping appears to maximize the cleansing process, which is important given the role of brain waste in the development of Alzheimer's disease and other neurodegenerative diseases. Still, more research, particularly human trials, needs to be done to corroborate these early findings. Sleep Apnea If you wake up breathless or have poor sleep quality that makes you feel tired during the day you might have obstructive sleep apnea (OSA). OSA is a sleep disorder that occurs when the muscles of the upper airway relax, narrowing or closing the airway, momentarily cutting off breathing. The most common causes of OSA and situations that may exacerbate it are: Being overweight or obese (including a large neck size) Abnormal upper airway anatomy (including a deviated septum) Using medications, drugs, or alcohol Aging Sleeping on your back REM or dreaming sleep Smoking Sleeping on your back allows the muscles that support the soft tissues in your throat, such as your tongue and soft palate, to temporarily relax thanks to gravity. As a result, you may develop common OSA symptoms like loud and chronic snoring, choking or gasping during sleep, and frequent nighttime awakenings or insomnia. Sleeping on your side keeps your airways open. Therefore, it's a preventative strategy that may alleviate your symptoms and improve the quality of your sleep. How Sleep Positions Affect Snoring Pregnancy During the second and third trimesters of pregnancy, some healthcare providers might suggest sleeping on your left side with your knees bent in a comfortable position. This posture may help improve circulation to the heart and allow for the best blood flow to the fetus, uterus, and kidneys. Of note, sleeping on your left side alleviates pressure on your liver because this position keeps the uterus off that large organ. Best and Worst Sleep Positions for Different Health Conditions Side Sleepers Positions Side sleeping usually occurs in one of three positions: Fetal: The fetal position, which is the most common side sleeping position, is when people are curled up in a ball similar to a fetus in the womb.Log: In this position, your legs are extended and your arms straight down, erect just like a log. This is the second most common side sleeping position. Yearner: In the yearner position, your legs are extended like the log position but your arms are extended like you're reaching for something. This is the least common side sleeping position. How to Sleep Comfortably Sleeping on your side is a comfortable way for many people to sleep, which explains why half of your sleep is on the side. Maintaining proper spinal alignment by using the right pillow at the right height and laying on a medium to medium-firm mattress usually leads to the most comfortable sleep. If you have GERD, you may want to avoid sleeping on your right side, and if you experience shoulder pain, you might want to avoid sleeping on the side that hurts or your side altogether. Which Side to Sleep On Heartburn and Side Sleeping If heartburn is keeping you up at night, you may want to turn over to your left side. Some studies have found that sleeping on the right side can aggravate heartburn, while sleeping on your left may calm it. The reason is not entirely clear, but some researchers hypothesize that right-side sleeping may relax the lower esophageal sphincter, between the stomach and the esophagus, allowing for stomach acid to reflux. How to Lessen Nighttime Heartburn Signs You’re Not a Side Sleeper It’s hard to know whether or not you're a side sleeper because the position you fall asleep in is not necessarily the position you wake up in. However, there are some tell-tale signs that you sleep on your back more than your side. You might be being tired all day long because sleeping on your back can collapse the upper airway. This causes you to snore loudly or wake up feeling breathless, signs of obstructive sleep apnea (which requires a medical evaluation to confirm a diagnosis). If you experience symptoms of acid reflux, it may also be a sign that you're sleeping on your back. You may want to elevate your head and torso to relieve symptoms. Best Sleep System for Side Sleepers Mattress Picking the right mattress is important for everybody, but it's especially important for side sleepers because one side of your body is bearing all your weight. It’s probably best not to have a mattress that is too soft or too firm. A medium to medium-firm mattress can help support heavier parts of the body without causing pressure buildup at the hips and shoulders. Best Mattresses for Side Sleepers Pillow If you sleep on your side, you might notice that it’s hard to keep your head aligned with your spine using one standard pillow. Using two pillows or a thicker therapeutic pillow is best to keep your head aligned with the rest of the spine. Benefits of Sleeping With a Wedge Pillow Summary Side sleeping offers many health benefits, from better spine alignment to reduced snoring. It also reduces GERD symptoms and is the preferred position for pregnant women and people with heart failure. A Word From Verywell Side sleeping may have some important health benefits, but it’s important to take all this new information that is gathered into context. If you have sleep apnea, for example, side sleeping is just one way to help alleviate your symptoms, but it should not be the only treatment method that you use. Also, shifting positions is a natural part of sleeping that you can't control. Thus, just because you commit to falling asleep on your side doesn’t mean that you will stay there. Frequently Asked Questions What’s the best side sleeper position? There is no “best” position to sleep in. The best position is often what’s most comfortable for you. However, if you're pregnant, have sleep apnea, or experience back pain, changing to side sleeping might help. Is sleeping on your side bad? Generally speaking, side sleeping is not bad. In fact, it’s been found to have many health benefits. How do you train yourself to sleep on your back? It’s natural to move when you sleep but there may be medical conditions that support sleeping on your back. The following methods can help you to avoid shifting while you sleep:Placing a pillow underneath your kneesPlacing a pillow under your lower back Creating a fortress of pillows around yourself.Of note, some people find that back sleeping increases discomfort in their lower back, but prefer to sleep on their back anyway. In this case, placing a pillow under your lower back while you sleep might help. Where should your arms go if you’re a side sleeper? Your arms should go in a comfortable position in front of you to avoid shoulder pain and body aches. What helps with shoulder pain from side sleeping? Changing positions and taking over-the-counter anti-inflammatories are first-line treatments for alleviating shoulder pain from side sleeping. 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chaput JP, Dutil C, Sampasa-Kanyinga H. Sleeping hours: what is the ideal number and how does age impact this?. Nat Sci Sleep. 2018;10:421-430. doi:10.2147/NSS.S163071 Skarpsno ES, Mork PJ, Nilsen TIL, Holtermann A. Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nat Sci Sleep. 2017;9:267-275. doi:10.2147/NSS.S145777 University of Rochester Medical Center. Good sleeping posture helps your back. Person E, Rife C, Freeman J, Clark A, Castell DO. A Novel Sleep Positioning Device Reduces Gastroesophageal Reflux: A Randomized Controlled Trial. J Clin Gastroenterol. 2015;49(8):655-659. doi:10.1097/MCG.0000000000000359 Lee H, Xie L, Yu M, et al. The effect of body posture on brain glymphatic transport. J Neurosci. 2015;35(31):11034-11044. doi:10.1523/JNEUROSCI.1625-15.2015 Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373-7. doi:10.1126/science.1241224 Javaheri S, Barbe F, Campos-Rodriguez F, et al. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017;69(7):841-858. doi:10.1016/j.jacc.2016.11.069 National Sleep Foundation. Sleep apnea. Kempf B, Kongsted A. Association between the side of unilateral shoulder pain and preferred sleeping position: a cross-sectional study of 83 Danish patients. J Manipulative Physiol Ther. 2012;35(5):407-412. doi:10.1016/j.jmpt.2012.04.015 By Shamard Charles, MD, MPH Shamard Charles, MD, MPH is a public health physician and journalist. He has held positions with major news networks like NBC reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments. 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