How Do You Sleep?

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Ever wake up stiff or in pain from sleeping?  Some pain that we endure throughout the day may be because of our prolonged posture throughout the night when we sleep. A good night’s rest is a key component for our body to heal and recover. This can come at a cost if we are experiencing musculoskeletal pain such as neck, back, or hip pain. Supporting our spine with an appropriate bed and pillow can set us up for an effective and soothing night’s rest. First, how do we know what type of pillow or mattress to use?  What if I am in pain, does the type of mattress and pillow matter? These are great questions, and this blog includes recommendations that can be used to guide you! There is no CORRECT pillow or mattress for every person.  The type of mattress and pillow varies from person to person. This is not a one size fits all kind of deal. Of course, if you are experiencing pain, please be evaluated by a qualified health professional that can tell you if these measures are appropriate for you and what you can do reduce your discomfort while sleeping.

Types of Sleeping Positions

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Many people toss and turn in their sleep. There are a number of crazy outcomes and positions tossing and turning while sleeping can result from which can lead to some pain and stiffness while waking up in the morning. Here are the three main sleeping positions used to get through the night:

• Back Sleeper
• Side Sleeper
• Stomach Sleeper

How do these positions affect our posture throughout the night?

Where is the most stress being placed on our neck, back, and hips during these specific positions? Neck and back pain are common complaints as a result of these positions. Not only can these positions create stress into the joints of our spine but also the muscles, ligaments, and tendons surrounding the joints of our spine. The amount of stress being placed on our spine and surrounding tissues can depend on the firmness of our pillow, the firmness of our mattress, as well as the height and weight of the person laying on the bed.

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Back Sleeper

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Sleeping on our back is traditionally the most neutral as well as the most neck and back friendly position used. It is the easiest position that places the least amount of stress on our low back, hips, and neck throughout the night.

Recommendation: Placing a pillow under the knees and using a supportive pillow under the neck is best for a good night’s rest. Placing a pillow under our knees brings our pelvis into a posterior tilt giving relief to our hip joints as well as placing our lumbar spine into a more neutral position. This takes pressure off our lumbar spine in our low back as well as our hip sockets. Placing a supportive pillow under our neck elevates our cervical spine to a more neutral position.

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Side Sleeper

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Sleeping on our side is the next up on our list on the most supportive spectrum. This position requires sleeping on our left or right sides with our knees bent or slightly extended. Although, some risks can be involved in sleeping on our side, there are good recommendations that can be used to ensure that we give our spine and body the most support throughout the night.

Recommendation: 1. Placing a pillow between the knees or lower thighs. This ensures that our low back and hips do not rotate which would place a great amount of stress on our lumbar and thoracic spine as well as our hip joints. 2. Placing a sheet, part of the comforter/blanket, or a small/soft pillow under the lumbar spine (low back). This can help the lumbar spine (low back) from sinking into the bed too much placing a great deal of stress into the joints, muscles, ligaments, and tendons of the low back. It is important to create the most neutral friendly posture into our lumbar spine while lying in this side-lying position. 3. Placing a supportive pillow under the neck. This prevents our neck from sinking or elevating into a more lateral flexed spine position. For example, a softer pillow can cause the neck to sink too much into the pillow placing our cervical spine into a more laterally flexed position towards the bed causing increased stress into the joints, muscles, ligaments, and tendons of our neck. Having too firm of a pillow can place this stress into a more laterally flexed cervical spine away from the bed. 4. Hugging a person or pillow. This allows our shoulders to be supported throughout the night by preventing them from being in a horizontally flexed position throughout the night causing stress into the humeral joint. This also prevents our mid back or thoracic spine from being rotated or twisted too much protecting the joints and surrounding soft tissues of the shoulder, scapula and spine. Using a body pillow can help with recommendations 1 and 4.

Stomach Sleeper

This position requires one to lay on their stomach with their head turned to one side or the other along with their hips and knees flexed or extended. Sleeping on our stomach places the greatest amount of stress on our spine and surrounding soft tissues and is the least recommended out of the three. This is due to our low back most often sinking into the bed placing a great deal of stress on the joints and tissues of our lumbar spine and low back. This also places a great amount of stress on our neck due to it being twisted and turned to one side or the other for a prolonged period of time while sleeping. Of course, recommendations can be given to prevent the amount of stress onto our neck and back.

Recommendation: Place a pillow under the front of our pelvis. This places our pelvis into a more posterior tilt causing our lumbar spine to come to a more neutral position. This places the least amount of stress on the joints, muscles, ligaments, and tendons of our lumbar spine and low back. This concept works best if your hips and knees are mostly extended. Using a thin pillow or no pillow for our neck is most recommended to prevent our cervical spine from being too extended and laterally flexed throughout the night. Turning our neck to the least restricted side can help ease tension and stress into the cervical spine and surrounding soft tissues.

Types of pillows and mattresses:

The type of pillow and mattress varies based on the person when sleeping on their back, side, or stomach. Most times, using a firmer pillow and mattress while experiencing pain is going to give you the most support throughout the night. This isn’t always the case but a good measure and guide to go by. For a heavier person, a firmer mattress and pillow for under their knees and neck will be the most recommended to use. This is because a heavier person may sink more into the pillow and mattress causing increased stress into the joints of the spine and surrounding muscles, ligaments, and tendons. Having a firmer pillow and mattress can decrease this stress and the likelihood of them sinking. For a lighter person, a softer pillow and mattress can be used. This is because a lighter person does not sink into the mattress and pillow as much as a heavier person would.  

Again, these measures vary on the person and what their desired comfort is. We always recommend each person, based on their presenting symptoms or height and weight, to try out different mattresses and pillows that suits their needs and wants. A pillow for one individual may not be the most appropriate for another. This same concept applies to mattresses as well.  It is not a one mattress and pillow fits all.

Conclusion:

Getting a good night’s rest is a great way for our bodies to recover but it is also important to have effective support for the joints in our spine and surrounding muscles, ligaments, and tendons to decrease aches and pains from occurring throughout the night. By having a supportive pillow and mattress, you can enjoy restful and peaceful sleep! These guidelines throughout this blog are only recommendations. As stated before, if you are experiencing any pain or symptoms from sleeping or even pain that is not directly related to sleep at all, please consult a health professional that can guide you in the right direction on which type of mattress and pillow that is right for you.  Feel free to schedule a visit at one of our beautiful locations located in Downtown, La Jolla, UTC, or Scripps Ranch to get customized recommendations for a great night of sleep!

If you have any questions regarding sleep and types of mattresses or pillows, hop on over to sleepfoundation.org.