The Worst Way to Sleep: How Your Sleep Position Affects Your Health

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Many of us understand the importance of a good night’s sleep.

It can do wonders for our mental and physical health.

It’s not just the amount of time you spend asleep that’s important (although it is important).

While you are asleep, your body’s position can make a big difference to your health, and some positions are definitely worse than others.

An Illustration of the worst way to sleep

Let’s take a look to see if we can find the worst way to sleep.

The Worst Way to Sleep

One element that really muddies the waters when it comes to finding the worst way to sleep is that different sleep positions can be better or worse for different health problems than others.

So there is often no single right way to sleep that will reduce your risk of every single health condition out there because each position will help some but harm others.

With that being said, we can still judge which is the worst position based on all the different evidence.

1) The Best Sleeping Position for Back Pain

Back pain, and especially lower back pain, is very common.

In fact, it is one of the leading causes of disability worldwide.[1]

It is very often a chronic condition that can have a huge impact on your quality of life.

And your sleep health is one of the factors that can make lower back pain better or worse.

Lower back pain can be affected by sleep quality, and the position you sleep in can also affect how bad your back pain is.

To reduce your back pain in the morning, you must keep your spine in a neutral position throughout the night.

If your spine is out of alignment while you sleep, this can put a strain on specific points in your back, which can then cause you pain.

The best – side sleeping

When you sleep on your side in a fetal position (with your legs drawn up towards your chest) or in a log position (with your legs straight out), your spine is naturally in its neutral position.

Illustration of 3 variations of the Best sleeping position for sleep apnea variations

To make the position more comfortable and to make sure that your spine is neutral, it can be a good idea to place a pillow between your legs.

Illustration of the adjustments required for sleeping in the best sleeping position for sleep apnea with a straight back

It is also recommended to place a pillow billow you waist in order to keep your back straight.

An illustration of how side sleeping can hurt the neck by curling the cervical spine
An Illustration of how comfortable side sleeping should look like

Not bad – back sleeping

If you can’t sleep comfortably on your side, then your second best option is to sleep on your back, ideally with a pillow under your knees, to make sure that your spine stays in a neutral position.

An illustration of how a pillow under the knees can help to have a comfortable sleep

The worst – stomach sleeping

When you sleep on your stomach, it forces your spine out of alignment, putting a strain on your lower back and making any back pain worse.

You can mitigate it as much as you can by placing a pillow underneath your stomach.

2) The Best Sleeping Position for Neck Pain

Neck pain is another common health condition.

It can be caused by an injury such as whiplash or a longer-term chronic condition.

The way your neck is aligned when you are asleep can have a big effect on how bad your neck pain is, and sleeping in the wrong position can actually be a cause of neck pain in and of itself.

The best – back sleeping

Sleeping on your back with a supportive pillow is the best position to make sure that your neck stays at a neutral angle.

An illustration of what is the right size of pillow for supine sleepers should look like

Not bad – side sleeping

Sleeping on your side can aggravate neck pain if you end up at an awkward angle.

Illustration of the required size pillow for sleeping in the best sleeping position for sleep apnea with a well aligned neck

Varying which side you sleep on can help to prevent strain being put on the same part of your neck each night, and a supportive pillow is a must.

The worst – stomach sleeping

Sleeping on your stomach will mean that your neck is going to be turned at an acute angle compared to the rest of your body and this can place too much strain on it, which can cause neck pain.

3) The Best Sleeping Position for Brain Health

Sleep quality is an important factor in brain health, and poor sleep can contribute to the development of neurological diseases[2] such as Alzheimer’s disease.

But the position in which you sleep can also have an impact on your brain health.

The best – side sleeping

There seems to be a good reason why side sleeping is the most common sleep position, and it could be related to the way our brains get rid of waste products.

There is a build-up of metabolic waste products in our brains throughout the day, and MRI scans in rodents have shown that side sleeping is the most effective position for these waste products to be removed.[3]

The build-up of waste products is related to the development of neurological diseases, such as Alzheimer’s, so sleeping on your side could lower your risk of developing these diseases.

The worst – any other sleep position

There isn’t any difference between sleeping on your back or stomach when it comes to the removal of waste products from your brain. Side

sleeping is the stand-out winner with this one.

4) The Best Sleeping Position for Snoring and Sleep Apnea

Snoring is an annoyance, especially if you happen to share a bed with someone.

But it can also disturb your own sleep, and it can be a sign of a more serious problem such as sleep apnea.

Sleep apnea is when you have short periods of your breathing stopping throughout the night.

The most common type is obstructive sleep apnea which is when your throat periodically closes, preventing you from taking a breath.

2 men lying down on a bed. One has sleep apnea and the other doesn't have. Showing the difference in air flow between the two men.

The best – side sleeping

The best position to relieve sleep apnea is to sleep on your side.

It doesn’t really matter whether it’s your left or right side.

Either way, it will help your throat to stay open throughout the night, reducing the chances of it closing up.

Patients with sleep apnea who sleep on their side have fewer sleep apnea episodes during the night.[4]

Not bad – stomach sleeping

Stomach sleeping isn’t ideal because you can inadvertently cover your mouth with your pillow, which can further restrict your breathing, but it doesn’t make your throat that much more likely to close up on its own.

The worst – back sleeping

Sleeping on your back is by far the worst choice if you have sleep apnea.

This is because gravity will be working to close your throat, which will increase the likelihood of you having a sleep apnea episode.

5) The Best Sleeping Position for Heartburn and GERD

Heartburn and other symptoms of GERD can get worse at night.

Gastroesophageal reflux disease (GERD) is a chronic condition where stomach acid flows back up into your esophagus and can cause a lot of discomforts.

The position in which you sleep can have an impact on how bad your symptoms are.

The best – side sleeping on the left side

The organs in your body are not arranged symmetrically.

And the position in which you sleep can affect your internal organs in different ways, depending on where the weight of your body is pressing and which direction gravity is pulling in.

With GERD, remember that your stomach is on the left side of your upper abdomen.

So sleeping on your left side means that gravity will be working to pull the acid down into the stomach, meaning that less acid will be pushed back up into your esophagus.

An illustration of how gravity aids to reduce acid reflux severity in left side sleepers

Patients with GERD who sleep on their left side show a reduction in symptoms compared to those who sleep on their right.[5]

Not bad – side sleeping on your right

Sleeping on your right side when you have GERD isn’t ideal because your stomach is situated above your esophagus, which can allow acid to drip into it, but it isn’t quite as bad as some other sleep positions.

The worst – back sleeping or stomach sleeping

If you have GERD, you should really try to avoid sleeping on your back or your stomach because both of these positions will aggravate your symptoms.

On your back, the acid that is released from your stomach is allowed to flow freely into your esophagus and lay there.

Sleeping on your stomach can actively push the acid out of your stomach, meaning that more will reach your esophagus.

6) The Best Sleeping Position for Heart Health

Heart disease is a health condition that can have a drastic effect on your quality of life.

And it is also affected by sleep.

Poor sleep quality can increase your risk of cardiovascular disease.[6]

But, again, the position in which you sleep can also affect your heart, and it is also because of how your internal organs are arranged.

The best – side sleeping on your right side

The best position to sleep in if you have heart disease is probably on your right side.

Just like with your stomach, gravity can affect how your heart operates, and the heart also lies on the left side of your body.

But unlike your stomach, it is better to sleep on the opposite side to where your heart is.

When you sleep on your right side, gravity prevents any extra pressure from being put on your heart.

Patients with heart disease find lying on their right side can reduce their symptoms.[7]

Take into account that not all experts agree with that.

W.Christopher Winter, MD, a sleep specialist, told CNN that sleeping on your right side is the worst thing for your heart.[8]

This is because sleeping on the right side puts a lot of pressure on the vein that returns blood to the heart.

Bur if you manage to sleep on your right side without putting too much pressure on that vein, you might be able to sleep on your right side without causing damage.

Not bad – sleeping on your stomach or back

Sleeping on your stomach or back results in uniform pressure throughout your chest, so neither specifically puts pressure on your heart.

They aren’t as good as sleeping on your right side because they do put some pressure on your heart, but if you can’t sleep on your right side, then either of these may be comfortable for you.

The worst – sleeping on your left side

When you sleep on your left-hand side, gravity and the weight of your body will both put pressure on your heart and can change the way your heart functions.

The ECG of healthy people changes when they sleep on their left side[9] and, for people with heart disease, sleeping on their left can worsen their symptoms,[10] including breathlessness.

7) The Best Sleeping Position for Pregnancy

Pregnancy is a magical time, but it is not without its stresses and worries.

Sleeping can become uncomfortable, especially in the third trimester, and many pregnant women can find it difficult to find a good position to sleep in.

But your sleep position can actually have a really serious impact on both your and your baby’s health.

The best – side sleeping

After your 28th week of pregnancy, it is really important that you go to sleep on your side and not your back.

A strong body of evidence has shown that sleeping on your back in the third trimester can increase your risk of stillbirth.[11]

This is because when you sleep on your back, the weight of your baby and your body can restrict some of the blood flow to your baby, depriving them of oxygen.

If you do wake up on your back, there is no need to panic.

It is the position that you go to sleep in that is important because that is the position that you will probably spend the majority of the night in.

So if you wake up on your back, turn over onto your side, and go back to sleep.

Using a pregnancy pillow can help to keep you in the right position.

The worst – back sleeping

Back sleeping should be avoided in the later stages of pregnancy because of the increased risk of stillbirth.

Stomach sleeping won’t be possible at later stages of your pregnancy because of your bump.

So Which Sleeping position is the Worst?

The worst way to sleep depends on what you prioritise in terms of your health, but let’s recap.

  • Side sleeping on your left – the worst for your heart
  • Back sleeping – the worst for brain health, sleep apnea and snoring, heartburn and GERD, and pregnancy
  • Stomach sleeping – the worse for back pain, neck pain, brain health, heartburn, and GERD

Final thoughts

Just like there is no single best way to sleep, there is also no single worst way to sleep.

It all depends on your health and your own needs.

Learning about the best sleep positions for your individual circumstances can have a big impact on your health and can help to improve your quality of life.

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