The purpose of this post is to answer the question of:
“What is the best sleeping position to promote good posture?”
What to expect in this post:
- The importance of your sleeping posture
- What is the best position to sleep?
- Exercises to do before you sleep
- How to test if a mattress is suitable for you
- The correct pillow position
- Other tips
The importance of having a good sleeping posture
Your sleeping posture is more important than you may think…
Not only does your posture matter when you’re upright, it is equally as important when you’re lying flat.
Tell me something… Have you ever woken up with a sore neck, shoulder or back?
Yes?… I am willing to bet that it could be due to your sleeping posture!
Guess what?… You lie down for over 2400 hours a year!
Now, let’s say we take the average time someone sleeps for is 7 hrs/day. That’s about 50 hours per week, 200 hours per month or 2400 hours in a year!
… THAT IS A LOT OF TIME LYING DOWN!
Don’t let your poor sleeping position be the cause of your bad posture!
What is the best position to sleep for good posture?
The goal is to encourage symmetry and alignment of the body.
Did you know… If you had “perfect posture”, you would have no difficulties lying flat on your back on the ground. No mattress. No pillow.
… But wait a minute… then why is it so uncomfortable for most people?
We are imperfect. Our posture sucks! We have developed poor alignment and as a result, our spines aren’t able to distribute forces as optimally as they were intended to.
“63% of Americans sleep on their side. Only 14% sleep on their back and 16% on their stomach.”
… I’m guessing that the remaining 7% are in even weirder positions?
My recommendation: Sleep on your Back
- Promotes greatest amount of symmetry
- Equal distribution of stress throughout the body
- Optimal position for posture
- Less likely to compress joints/muscles
- Encourages snoring
- May place more stress on the lower back
- May be uncomfortable for people with bad posture
Points to consider:
a) Place a pillow underneath your knees
This will cause a slight bend in your hips and knees and allow your lower back to flatten against the bed.
In turn, this position will alleviate any tension throughout the lumbar spine (especially in those with anterior pelvic tilt and/or tight hip flexor muscles).
[For those that are like this, have a look at this post: How to fix an anterior pelvic tilt as this may help you address the factors leading to this issue.]
Note: Depending on your level of comfort, you may require to try different heights of pillow under your knees until you find the most supporting and comfortable position.
b) Support your arms
Place a pillow by your side to help offload the weight of your arms.
This is particularly helpful if you have rounded shoulders which tend stick forward even when you lie down.
We need to support your bad posture for now, but also challenge it along the way.
If you have reasonably good posture, you may not require to support your arms.
If you sleep with your arms behind your head (which is not a problem), make sure you do not have any shoulder issues which may be impacted by this outer range position.
c) Use Gokhale’s method of “Stretch lying”
When you sit for long periods of time, there is a large amount of compression going along your spine.
I am a huge supporter of the Gokhale’s Method of stretch lying to de-compress the spine whilst down.
Think about elongating your spine as you lie down!
- Lie down on the back.
- Bend both knees and place feet hip width apart on bed.
- Prop the upper body onto your elbows.
- Slowly peel onto the bed one vertebra at a time.
- Place hands behind the head and slowly elongate the back of the neck.
- Set shoulder blades down towards the feet.
- Straighten out and relax the legs to the side.
… Still uncomfortable sleeping on your back?
Try sleeping on an incline.
If for whatever reason you can’t lie on your back (breathing difficulties, snoring, back pain etc), you can try sleeping with a bit of a slight incline at the hip.
(I tend to adopt this position when I have a flu and can’t lie on my back without my nose blocking up.)
If your bed does not allow you to adjust the bend, then you may need to stack a bunch of pillows until the desired angle is reached.
The next best option: Sleeping on your side
People with bad posture will generally prefer to sleep on their side.
If you think about it, the position resembles the posture you may have whilst sitting (… I call it horizontal slouching).
If you are used to sleeping on your side, there is no need fret. (There is a more ideal way of doing it!)
The main thing to consider is keeping the spine alignment in a straight and neutral position.
- Reduces snoring
- More comfortable for people with bad posture
- Good for pregnancy
- Increases stress on one side
- Higher risk of misalignment (especially if you have big shoulders or hips)
- Alignment is largely dependent on support from mattress
The correct way to sleep on your side:
Points to consider:
a) Place a pillow between your legs to prevent the upper leg from rotating your body.
b) Support your upper arm with a pillow to off load the stress on the shoulder.
c) Adequate support from your mattress is imperative in maintaining a neutral spine. Click here to determine if a mattress is suitable for you.
d) Do not assume the foetal position to the extent where you are curled up into a ball. This will compress your body and promote bad posture.
e) Remain lengthened and elongated throughout the spine. Imagine someone is pulling your head to make you taller.
Note: If you suffer from any shoulder issues, do NOT sleep on the painful side! Either sleep on the other side or on your back.
Don’t do this: Sleeping on your stomach
Do NOT sleep like this!…
(Unless you want some sort of neck injury.)
In this position, your neck is rotated all the way to one side which places a large amount of pressure through the neck structures.
(If you suffer from neck pain, check out this post: Neck exercises – The solution for neck pain.)
It will also encourage the rounding your thoracic region (aka slouching) and promote sway back posture.
The only time this position will be safe for you is if your bed has a face hole for you to keep your neck straight. (like the ones in massage parlours)
How many pillows should I use to support my head?
What is the magical number of pillows? 1, 2, 3 or even 4?
The trick is using the pillow as a means of supporting and promoting neutral alignment of your spine.
It really depends on your posture and sleeping position.
Ideal pillow placement to maximize head support
a) If you are on your back
Place the pillow in the small of the neck.
There should be complete contact of your neck.
There should be no pillow contact on the back of your shoulders.
Make sure that the back of your head is in contact with the pillow, and not that top.
If you have a poked neck, you may require a slightly thicker pillow to support your head.
Since your head sticks forward, you will need to accommodate this posture whilst you work on your forward head posture.
b) If you are on your side
Place the pillow in the small of the neck.
There should be complete contact of your neck.
There should be no pillow on the side of your shoulders.
When to change your pillow
How old is your pillow? Have you even changed it before? Do you need one new one?
Do the pillow scrunch test:
Scrunch up your pillow. Let go.
Does it spring back to the original shape immediately?
If it doesn’t, consider purchasing a new one.
“But… I move around in my sleep!”
So do I.
… And that is perfectly normal.
My advice that I would give to you is to start in a good position, support this position with the use of pillows, and hope that you wake up in the same spot.
It is not the end of the world if you move into a “not so good” position, but it is always important starting in the ideal position to set yourself for success (… even when you’re fast asleep).
How to determine if a mattress is suitable for you
Are you looking for a mattress? Not sure how to test if a mattress is good for you?
The general rule of thumb when buying a new mattress is to aim for as firm as you can comfortably tolerate.
How do I test the amount of firmness? … Do the 2 minute test!
Here is how to do it:
- Pick a mattress you are wanting to test.
- Lie down on your back.
- Maintain this position without moving for 2 minutes.
- If you feel you need to fidget or change positions before the 2 minutes is over, the bed is not suitable for you.
TIP: Mattress too expensive? And your current one is too soft? Put a ply wood underneath to give it more support.Not ideal, but I guess it’ll have to do if you have no other choice.
– You are going to move around: Chances are that you will not be able to stay in the same position throughout the night. That’s fine. You will actually find the more comfortable you are, the less you’ll move around. As your body becomes used to your new sleeping position, it becomes easier to remain in position.
– Get up slowly: When you wake up, make sure that you take your time rising from your bed. If you move too quickly, especially if the body has been in one position for a long period of time, can cause you an injury.
– Someone else in the bed? If you have someone else sleeping next to you, it may be a common practice to snuggle next to them. No problem with showing some love… But, exercise caution when you are about to sleep. If you are entangled with your partner/sleep buddy, this may compromise the ideal sleeping posture.
- My recommendation: After you have finished your hugs, separate, and assume your sleeping position. You might need to explain to your partner why you are doing this, otherwise they may think you are brushing them off!
– It takes time. You have been sleeping a certain way for many years now. It is going to take some time to wean into your new ideal sleeping posture.
Now that you have a better idea of the correct sleeping posture, have a look at my morning routine to find out what I do every morning after I wake up to prime my postural muscles.
Please feel free to leave me a comment down below.
I’d love to hear from you!
51 thoughts on “Best sleeping position”
Hi Mark !
I have a high arched back
I am pregnant and I need relief while sleeping, every position is soo uncomfortable!
Sounds like you have Hyperlordosis.
If you have tried all of the usual things such as changing the firmness of the mattress and trying different sleeping positions, here are some quick suggestions:
– In the side lie position: Place pillow between knees, small pillow underneath the waist crease, hug a pillow with arms, small pillow underneath belly bump.
– Use a SIJ belt (if you have ligament laxity). Also depends how big your belly is at the moment.
– Gentle strengthening exercises for the hips and lower back. (best to be guided by a trained professional)
– Consider using a pregnancy sleeping pillow
All the best.
I sleep on my back and use a very flat pillow. My neck does not touch the pillow at all. If I ensure my shoulders are not touching the pillow at all and kinda scrunch up the bottom of the pillow to fill the void under my neck, I end up with a very sore, stiff neck the next day. So I don’t do that and I just leave the gap and there might be an inch of pillow covered by my shoulders. Is this bad? Will I eventually get used to the neck support? Or do I need to address my forward head/rounded shoulders first?
I would recommend that you address the forward head, rounded shoulders and any thoracic kyphosis.
Very helpful stuff.
Just one question,
if i have only ONE rounded shoulder, will propping that one arm up help as well?
Best Regards Buddy
I’m not sure what position you are referring to when you say propping one arm up. Do you mean supported the rounded shoulder when you are on the side?
Ps. With only one rounded shoulder, this could be due to a twisted spine.
Thank you so much for all the information on this site! I can’t imagine how much trouble it’s saved me down the line. I had horrific posture and fortunately managed to catch it early.
I really want to sleep on my back, but every time I try, I just… don’t sleep, despite the fact that I fall asleep in 5 seconds flat on my side. I have no idea how long I could lie there awake; I always give up and turn onto my side and fall asleep immediately.
I have no pain, no sleep problems, my mattress is fine, and I’m nowhere near overweight. My best guess is that it feels too much like standing, and my brain just doesn’t get the message to sleep, but I have no idea if that’s true! Weirdly, I actually find lying on my back more comfortable than my side because everything is aligned (I don’t even need a pillow) and my (very bony) knees and ankles aren’t pressed together, but I still can’t sleep.
Any ideas on how to fix that?
It sounds like it could just be a matter of giving it some time to allow the body to get used to it.
Don’t be afraid of sleeping on your side though! It is not inherently bad!
Hi Mark, I have a question. You mentioned that putting a pillow under the knees will help flatten out the lower back. However, will this not lead to having a postural flat back on the long run?
I decided to sleep on the floor a few nights ago because my back and neck pain were becoming unbearable and I woke up feeling better than ever.
My posture has improved so much by sleeping on the floor for a week. However I have a slight knee varus that seems to be geeting worst.
According to you, would the pillow under my knee help my knee varus?
Pillows under the knees will help take some pressure off the lower back. If you have no issues with your back, you can skip using the pillow altogether.
You mention the knee valgus getting worse. It is not likely that the sleeping position is making it worse. Any other potential activities that might be contributing?-
Thank you so much for the clear explanation of ideal pillow support for different sleeping positions to maintain or improve our posture. I have been looking into cervical support pillows and have read that these can support both back and side sleepers. Back sleepers can place their head in the center where there is neck support and a dip in the center for the back of the head, and if you turn to either side, the pillow is thicker to support the side of your head. Would you share your thoughts on the benefits or downsides of using this type of pillow?
I haven’t come across these types of pillows before actually! I’ll need to research it a bit!
But by what you have told me – it sounds like it can be used by both back and side sleepers.
You will still need to make sure there is an adequate amount of support for the neck and head (of course- everyone has different sized heads/neck/shoulder)
Is it normal if my knees and feet roll completely flat instead of them pointing to the ceiling when I lay on my back
If you mean they both roll out to the sides, it might mean you have relatively tight glutes.
Thank you for explaining this in such a lovely language.
It’s currently 1:37 AM and I’ve been trying to find a good sleeping position for rounded shoulders. I am now going to sleep without pillow and my hands on my stomach with me elbows rotated out a little bit, this is the first time I feel really comfortable, thank you so much!
Hope it helps!
Also – make sure you have a good mattress!
Putting a pillow under your knees can cause deep vein thromboses.
Is it good to sleep without a pillow?
It can be.
The only issue is that so many people have a forward head posture that a pillow is required to support the head/neck.
If you feel comfortable and your body responds well to it, go for it!
I have a left rotated pelvis and I’m a side sleeper. Would it be better to sleep on my left side or right side? Thanks!
You can sleep on either side.
But if you wanted to steer your pelvis away from the left side it would be best on the right side. (push your left knee out away from you in this position)
Thank you for discussing sleep posture. We spend 1/3 of our lives in these positions and nobody ever instructs us as to which is best and what to avoid! I am a total bad posture side sleeper. I even have my top leg position rolled forward, making my lower hip almost flush with the bed. I find it extremely comfortable. With the information you have provided, I am going to work toward better sleep posture and discuss it with my family so they can avoid posture impairing sleep positions too. We all have firm mattresses at least!
Thank you for making this information available!
Thanks for leaving me a comment.
All the best with your sleeping posture! :)
Hey Mark, thank you for helping us.
What are the signs of an excessive firm matress in the body?
I predominantly sleep in my back and wake up feeling mild pain/tightness in the thoracic spine and ribs in the latissimus region. Maybe it is too firm?
How your body feels first in the morning should be your first indicator to whether or not your mattress is suitable for you.
If you feel areas of excessive pressure from the contact points, inability to stay comfortable in one position, increased pressure in your muscles etc – this may indicate your bed is too hard.
Thank you brother
Doesn’t sleeping on the back put pressure on the discs along the spine that are supposed not to have any weight on them?
There’s always going to be some pressure on your discs.
Sleeping on your back will help distribute the load (Left vs right) as evenly as possible.
But Mark sleeping on the side/back doesn’t put any weight on the discs (it does in other places though). I was told never to lean on a chair because it puts pressure on the disk and you’re supposed to sit on your sitting bones (putting the weight there). Isn’t this the same principle =) ?
There will still be pressure on the discs even if the bed is not physically touching your back.
Hi mark I don’t know how to correct my posture,my right shoulder seems more pull out backward than the other,when I benddown the muscle seems more pushout more than the rest
I love you, Mark. You’ve given me hope for my back. I’m going to try all of your exercises for the next few weeks. Thank you for sharing your expertise!
Thanks for dropping by EP.
Let me know if I can help you.
Watch out for reflux when lying on your back. Mine is so bad that acid backs up to my trachea, which snaps shut in reaction, causing me to choke awake. This happens every time I sleep on my back and I am NOT overweight. This is more common than most people realize and is one of several causes or contributors to sleep apnea.
100% agree with this.
Please be careful if you have gastroesophageal reflux disease (GERD).
I have rounded shoulders which I’m working on. I may also have mild fibromyalgia to make things a little more painful. Anyway, for the past several months I’m having pain in the clavicle area while sleeping and especially in the morning. When I get up and bring them down and back they go through a series of pops and snaps as they settle in.
I sleep on my back and side and can’t seem to get comfortable. I also have neck pain and stiffness in the morning and throughout the day. Would a posture brace during sleep help? I think and elevated mattress might help as well since gravity will keep my shoulders down at least. Elevated knees will also help with the lumbar spine as you mentioned.
Thanks for any information!
Hi Chris O.
1. Try a subclavius muscle release:
Gently press and massage this muscle.
2. You might need to check if your upper back is rounded:
This will cause your shoulders to lift forwards as you lie down.
3. Don’t worry about the posture braces. There are better ways to address this issue.
4. For your neck issues, I recommend having a look at these two posts:
Forward head posture
Should I use pillows under my legs if I have swaybcak posture and my hip flexors are long and weak?
It is fine to do.
As long as you don’t sleep on your stomach!
The first thing that I would look at is the pillow you are using. The more forward your head is, the most support you will require.
If you have a loss of cervical lordosis, check out this post: Forward head posture correction.
With a sway back posture, it is likely your spine will not like sleeping flat on the back. You can try sleeping with your knees bent with your feet on the bed or having them supported by pillows.
So last year after some bizarre circumstances, I ended up using my camping hammock in lieu of a bed for the entire year. I use it outside all the time, it’s in the style of a Brazilian gathered end hammock and I’ve had some of my best nights of sleep in it (it’s an Eno Double Nest if that helps!) The rocking motion to fall asleep, the feeling of sleeping on air because of the lack of pressure points, and how it forces me to lie on my back was all helpful in deep sleep and waking up without the lower back and neck pain I had as a side sleeper in bed…. I know some indigenous South American tribes slept in hammocks for generations. Any thoughts on this? I love how much space it frees up in my room! And for the record, I sleep on a diagonal counter to the curve rather than on the banana like curve, causing the fabric to flatten out.
Sounds like it’s cozy! (and space efficient)
how do you position a patient in lying.
It depends on what you are trying to do with the patient.
Thank you so much for all the great advice on your site. I have a question about mattresses. Would you recommend a Tempur mattress (or good quality memory foam one)?
Tempur do have great mattresses..
But you need to find one that caters for a) your posture, b) sleeping position of choice and c) any aches/pains in your body.
The general rule – sleep on a mattress that is as firm as you can comfortably lie on.
I personally sleep on a Sealy Posturepaedic Mattress.
Thanks for your pillow tips. I do struggle with some stiffness in my neck in the mornings and I think it is because my pillows are too high. It is a bad habit of mine, but I have a hard time sleeping when my pillows are not high enough. In any case, my pillows do not pass the scrunch test and it is probably time to get new ones. I will just have to make sure these ones support my neck properly.
Well, I guess I have poor posture. I can’t lie comfortably on the ground without a pillow. Honestly, I am not normally comfortable on the ground at all. I much prefer my bed. Thanks for your tip about how to choose a good mattress by the way. I have to admit that I don’t often lie down for more than thirty seconds when choosing. I’ll have to be more careful next time.
Thanks for visiting! Most of us have a less than ideal posture… but hey, there’s a multitude of things we can do to try to improve on it. Hope the tips help.