Best Sleeping Position?

What do you recommend as the best sleeping position? I’ve heard that sleeping on your back is best if you have back pain or if you snore. Is that true?

– January 6, 2015

Sleeping on your back is considered best if you have chronic back pain, but it won’t help with snoring. The advantage of sleeping on your back is that it allows you to keep your head, neck and spine in a neutral position. It is also said to help prevent wrinkles, but I’m not so sure about that. I found only two studies on the subject. One, published in 2013, found no effect after evaluations of 100 women, while the other, from 2004, found increased horizontal or oblique wrinkles on the faces of women who reported sleeping with their faces buried in their pillows. (I saw no mention of the women’s ability to breathe in that position.)

Sleeping on your back with your head, shoulders and upper torso elevated is recommended if you have heartburn. This position helps gravity direct the flow of stomach acid back where it belongs. Avoid raising your head alone by sleeping on two pillows – that could make matters worse.

Sleeping on your side is considered the second-best bedtime position. It is recommended for preventing neck and back pain, reducing heartburn and snoring. According to the American Pregnancy Association, the best position for pregnant women is sleeping on the left side because it increases the flow of blood and nutrients to the placenta and the baby. Sleeping on your side is reputed to promote wrinkles and contribute to breast sagging, but I cannot find any scientific documentation of this.

The worst sleeping position of all is said to be on your stomach, even though it may minimize snoring. (But if that’s your problem, you have other options that don’t include your sleeping position.) Sleeping on your stomach habitually is reported to lead to aches and pains in your neck, back, muscles and joints. I slept on my stomach for many years but trained myself to sleep on my side. I have always found it difficult to sleep on my back.

Incidentally, in its “Healthy Sleep Tips for Women,” the National Sleep Foundation recommends only finding a comfortable position, and notes that prior to or during menstruation when women can experience cramping, nausea and muscle aches, sleeping on the side or back can help minimize pressure on tender areas.

Andrew Weil, M.D.

B.S. Kotlus, “Effect of sleep position on perceived facial aging,” Dermatological
Surgery, September 2013 doi: 10.1111/dsu.12266

N. Sarifakioglŭ et al, “A new phenomenon: “sleep lines” on the face,” Scandinavian journal of plastic, reconstructive surgery and hand surgery, 2004;38(4):244-7.

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