Sleeping Positions and Your Back

The spine is designed to follow a particular path from the base of the skull to the pelvis. The picture shows the different spinal regions and their natural curvature. Maintaining this curvature is often difficult. As the body ages, the shoulders and pelvis tend to round and tilt forward, exaggerating the thoracic and lumbar curvature. The head also drifts forward, causing strain in the cervical vertebrae. With the rate of obesity in the U.S. and the amount of time human bodies now spend at desks, these changes are very commonplace even in the younger population. Being conscientious of your sleeping positions can save your posture.

This is probably the easiest position in which to best protect your back.

• If you sleep with your head on a pillow, use only one relatively flat pillow. A cervical roll can allow a more natural cervical curve during sleep.

• Place a pillow or two under your knees, allowing them to bend. This allows the pelvis to rest in a natural position and removes strain from the lower back.
• Keep your arms by your sides. Sleeping on your back with your arms over your head can cause nerves in your shoulder area to be pinched and you may wake frequently with numbness or tingling in your arm(s) or notice that you have developed some of these symptoms during the day. Try changing this habit.

While this can be a comfortable position for most, it comes with pros and cons. Sleeping on your side can help with upper airway disorders during sleep, but it can also impact your shoulder, neck and upper back alignment. Try these tips to protect your joints.

• Be sure to have a pillow thick enough to take up the space between the end of your shoulder and your cheek to reduce the pressure placed on the shoulder structure and thoracic/cervical vertebrae.
• Place a pillow in front of you (along your chest) and place your top arm on that pillow. This prevents your arm from crossing your mid-line and further rounding your shoulders.
• Place a pillow between your bent knees. It should take up the space between your thighs, knees and ankles. If you have long legs, get a king-sized pillow or body pillow for this. Sleeping in this position keeps your legs aligned with your hip joints.

Stomach sleeping is generally not recommended. Sleeping on your stomach puts your spine in an awkward position. The lumbar curve exaggerates, putting increased pressure in the low back. The neck has to be rotated 90 degrees to the right or left, and on a pillow this not only places the neck in an extreme position for a prolonged period of time, but adds pressure to the head/neck. Add to it that the arms usually go above the head for this position, impinging nerves, and you have a less-than-ideal situation.

• The number one recommendation is to try to change this habit.

• The next best thing is to find a stomach-sleeping pillow that will better support spinal alignment.

• Sleeping on your stomach with your pillow under your hips instead of your head can help somewhat.

People with health problems, like breathing difficulty or digestive troubles, often sleep better in an elevated position. Keeping your head elevated at least 30 degrees can help with breathing, lessen snoring, and aid in reducing reflux. Use a wedge pillow to support your vertebral column, instead of laying on a pile of pillows. An adjustable bed or hospital bed can achieve the same function.

If you or a loved one are on a feeding tube or oxygen therapy at home, a wedge pillow could make a world of differnece in the quality of sleep.