Sleeping Posture

You spend a third of your life in a sleeping posture. The options are to sleep on your stomach, on your back, or either side.
Optimal posture gives us a balanced body, the curves of which have evolved to dissipate the stresses and impact of walking and running. Our alignment should be as near to symmetrical as possible.
In my experience of teaching Pilates, I rarely see a client with good alignment who has musculo-skeletal pain, unless they have had a recent trauma. I do see many clients who have poor alignment: in helping them I am interested in how they stand, walk, and sit. And how they sleep.
In my experience, I have found that many of my clients who have the worst back pain, sleep on their fronts.


Sleeping on your front.
This disturbs the body's alignment in many ways - the neck is twisted to one side, and the head is on a pillow. Just try that now - turn your head to the left, say, and then take it back over your shoulders, as if supported by a pillow, and hold it there for a while. (8 hours would be over-doing it, but a few minutes will give you an idea.).
The ribcage and the airways are compressed and twisted, and so breathing is compromised. Often the legs and pelvis are twisted to one side:, this opens up the joints in the pelvis (the sacro-iliac joints), and twists the joint between the lowest lumbar vertebra and the sacrum, and also twists the lumbar spine. The muscles and tendons and ligaments which support the skeletal system in waking hours are relaxed during sleep, and so on waking and moving these soft tissues object to the position the sleeping skeleton has contorted into. Ouch!

So, all in all, not a good way to sleep.



Sleeping on the back.
The main problem with sleeping on the back is that snoring is more likely in this position, and so sleep is interrupted. If you have lower back pain, and you sleep on your back, try placing a cushion under your knees. This will keep your lumbar curve happy during the night. One pillow under the head should suffice unless the shoulders are very broad: too many pillows pushes the head forward, re-inforcing a tendency to "head-poke".



Sleeping on the side.
This is the preferable sleeping posture.

Again, one pillow should suffice (see illustration) . Care should be taken that the top leg does not overlap the lower leg and rest on the bed - here the pelvis and the lumbar spine will be twisted.




In the illustration you can see how good the alignment is of the spine and pelvis, with the legs lined up above each other.
If you have lower back pain or sacro-iliac pain, a flattish cushion between the knees
will optimise the alignment of the legs and the pelvis.

It is said that it's best to sleep with the heart uppermost (ie sleep on the right side - not like the picture!) - this optimises the cardio-vascular system, and it makes sense to me.
So sleeping on the side is the best sleeping posture.

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