When it comes to healthy sleep, there are so many factors to consider: temperature, lighting, timing, and much more. While there are some hard and fast expert-approved rules for optimal sleep hygiene (no social media scrolling before bed, please!), some topics, like sleep position, are a bit more nuanced. Research indicates the predominant sleep position in adults is on the side, and other studies say that individuals who prefer to sleep on their side will sleep better than those who like to sleep on their back.
Preferences aside, there’s some science to back up the notion that supine sleeping is actually the healthier choice. So, should you switch to snoozing on your back — and how do you train yourself to do that if you’re a chronic side sleeper, anyway?
The potential pros of sleeping on your back
While most people seem to naturally curl up on their side, there are documented health benefits to sleeping flat on your back, including potential pain reduction and skin improvement. “Sleeping on your back is probably more orthopedically helpful if you have shoulder, hip, or knee pain,” says Dr. Chris Winter, neurologist, Sleep.com advisor, and author of “The Rested Child” and “The Sleep Solution.” “It's also probably a better position cosmetically for avoiding wrinkles and/or sagging breasts, etc.”
Laying on your back is more likely to keep your spine in alignment during the night, which may help you avoid putting unnecessary pressure on certain parts of your body. According to one study, sleep posture is an important part of preventing neck and shoulder pain, and the best strategy is to sleep supine (lying face upward) with both hands at the sides or on the chest. Another study indicated supine sleeping may be beneficial for lower back pain, but more research is needed to confirm this.
“Yes, your posture is important even when you sleep,” says chiropractor and wellness consultant for The Toronto Argonauts and author of “Take Good Care: 7 Wellness Rituals for Health, Strength & Hope,” Dr. Dwight Chapin. “Back pain sufferers know that the clinical path to recovery is complicated. Research shows that sleep is among the most critical factors for peak physical performance, memory, productivity, immune function, and mood regulation. The solution to back pain must effectively address pain management and the underlying root cause of spinal dysfunction. This starts with healthy sleep habits.”
According to Chapin, lying on the back allows the head, neck, and spine to relax into their natural alignment, which reduces daily stress placed on the body. “As a side benefit, if you suffer from tension headaches, congestion, heartburn, or acid reflux, sleeping on your back with your head elevated may also help reduce associated symptoms,” he says.
When it comes to your skin, you may not think of your sleep position as a possible contributor to problems, but there’s some evidence to suggest that supine sleepers are more likely to avoid wrinkles on their face and chest. According to one study, side or stomach sleeping causes tension in facial tissue, stretching, and tearing of the skin in all directions, which, over time, can contribute to wrinkles.
While there’s no solid evidence to support supine sleep as a prevention strategy for breast sagging, many dermatologists and plastic surgeons advocate for back sleeping, theorizing that it may help breasts retain their shape and prevent strain on the chest skin.
How to train yourself to sleep on your back
While Winter says the majority of his clients actually try to train themselves to get off their backs while sleeping, there are some people who may want to experiment with adopting the supine position for pain or skin concerns. “I imagine devices like this snoring pillow could be adjusted 90 degrees to sit on an individual's side, thus preventing the position. Body pillows might help as well,” Winter says.
Chapin also advocates for pillows, suggesting at least one for the head and one for the legs. “While lying on your back with your head resting on a pillow, place another pillow under your knees,” he says. “This will reduce tension on the lower back. If you find you are still turning your head to one side, try using pillows or a small rolled-up towel to support the neutral position of your head and neck.”
It’s also worth noting that even snorers may want to reconsider totally quitting the supine position, as some research indicates that sleeping at an incline can potentially reduce snoring as well as acid reflux. “Elevating the head of the bed and raising the legs (zero-gravity position) can be helpful in terms of both comfort and preventing side sleeping, which is difficult when the head of the bed or feet are elevated,” Winter says. This is when investing in an adjustable bed may be the way to go, as many have zero-gravity positions.
While there’s no scientifically proven way to train yourself to become a back sleeper, there are some strategies you can try if you’re hoping to switch things up:
- Prop yourself up. As Winter suggests, special pillows may help physically keep you in place throughout the night so you remain on your back. But if you don’t want to purchase a new one, simply grab a pillow you already have and try placing it under your knees as you drift off on your back. This positioning can help support your spine and keep you comfortable, but if you really want a physical barrier to keep you from rolling onto your side, try surrounding yourself with fluffy pillows around your hips and torso to prevent you from budging. If you’re looking for a long-term investment, adjustable beds can help you achieve this position while not having to worry about pillows shifting or moving in the middle of the night. If you’re worried about snoring, some even have sensors to adjust the bed if you start snoring in the middle of the night.
- Choose a mattress that supports a supine position. If pain is your main issue, you may want to consider a new mattress. Research suggests that a medium-firm mattress may help promote comfort, sleep quality, and spinal alignment. Having a supportive mattress may help you feel more at ease snoozing in a new position.
- Avoid eating a large meal immediately before bedtime. If your goal is to fall asleep on your back, then you’ll want to do everything you can to eliminate factors that could make that position uncomfortable. Eating too close to bedtime may contribute to nighttime heartburn and negatively affect sleep quality, so try to avoid heavy or large meals within two or three hours of hitting the hay.
When it comes to the exact type and positioning of props, Chapin says individuality is key. “Back sleepers typically need thinner pillows, so their head is not thrown too far forward,” he says. “There is some benefit from the use of cervical pillows with extra loft in the bottom third of the pillow to cradle the neck. Placing a pillow under your knees and at your sides will help make this position more comfortable and make rolling over onto your stomach more difficult. Your final pillow selection will be influenced by your body size, shape, and sleep habits. Also, note that most pillows wear out in a couple of years and should be regularly replaced.”
There may not be a one-size-fits-all strategy for sleep posture training, and back sleeping may not be right for everyone, but good sleep hygiene is for everyone. If you’re curious to see how sleeping on your back might be beneficial (or you’re simply desperate for more quality rest), be sure to work on all the basic tenets of good sleep hygiene, including reduced light exposure, sleep-wake timing, proper room temperature, and more.
“Like any new habit, learning to sleep on your back can take practice to master,” Chapin says. “Be patient, start in this position each night, and eventually, your body will become used to it, and your back will thank you.”