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The things we do in our sleep that destroy our posture. 

WORDS Dr Steven Lockstone 

Sleep. Everyone wants it, but we simply don’t get enough of it. And when we do, there’s a good chance we’re not even doing it right. 

Sleep is a critical component to a healthy body. While we are receiving our seven to eight hours of recommended shut eye, our body is repairing itself through a series of actions including energy restoration, release of hormones to promote growth and development and muscle relaxation. So while you can eat all the vegetables under the sun, if you’re not getting the right amount or quality of sleep, the body will struggle to perform to the best of its ability.  

When we do manage to drag ourselves to bed, it’s important to know how to sleep. It’s fair to say that sleep is not something we’re commonly taught, so there’s no telling if we’re doing it right or wrong. Sometimes it takes a partner to tell us how we sleep or if worse comes to worse, some form of muscular pain. 

Whatever it may be, there are common positions we morph into when we sleep that should be corrected to optimise sleep and minimise long-term health effects. 

First things first, how should we be sleeping? 

On the back

It’s not the most natural position to rest into, however for the sake of the back and neck, lying flat on the back with both arms at the side of the body is the preferred position. 

From a postural point of view, this promotes a neutral position for the spine, neck and head as well as reduce strain on the body. The correct pillow will also help to support your spine alignment as well as neck position. Typically, a cushioned pillow will help promote alignment between the neck and the rest of the body. As a general rule, the head should be slightly elevated and rest no lower than the shoulders, i.e. flat on the mattress. This promotes a clear breathing path with minimal obstruction. For additional support, adding a pillow under the sacrum can also promote optimal alignment of the spine, especially if you have a pronounced arch back. 

Unfortunately for some people, sleeping on the back induces sleep apnea and consequent snoring. This is when the tongue collapses into the mouth and obstructs the airway, hence creating a stifled breath and disruptive noise, specifically for sleeping partners. 

So here’s what not to do.   

Side sleeping 

Sleeping on our side can incur unwanted stress on our internal organs that are consequently under pressure to maintain alignment. The curvature of the back can also restrict free airflow as well as negatively impact our posture, which may lead to long-term lower back pain. Sleeping with the knees stacked can also put pressure on the bones and joints, especially if the position is held all night. 

It is also common for side sleepers to rest on their limbs, which can send them into another form of sleep. This can be painful if you wake and need to use your arms, but cannot due to the sensation of pins and needles due to loss of blood to the area.  

Transitioning to sleeping on the back may be difficult, in the meantime place a pillow between the knees to help cushion and protect the bones and joints. It’s also helpful to keep the arms rested along the side of the body, instead of nestled up into the chest. Curling the arms into the chest puts strain on the spine and joints in the arm, which may result in pain after some time. 

Fetal position 

Curling up into the fetal position is a reactionary position for human beings and is associated with comfort, but it has significant impacts for the joints of the body. 

If the knees and chin are tucked in toward each other, the joints are compressed to hold the position and the neck and shoulder are put out of alignment. If you suffer from arthritis, this position may cause further stress to the joints and therefore increase inflammation. 

This position also restricts breathing due to the curled up position of the body. 

Stomach sleeping 

It’s usually the things we love that are the worst for us, unfortunately sleeping on the stomach falls under this category. Sleeping on our stomach defies the natural curvature of our spine as well as puts pressure on our neck for a sustained period. 

If you think about it, if this position is maintained each night, the hours the body is put in a compromising position can add up to some serious pain that may be in the pipeline. 

One way to reduce the stress of sleeping on the stomach is to place a pillow under the stomach to restore the natural curvature of the spine so it is not too out of alignment. 

Making accessory corrections 

Since we spend almost a third of our lifetime in bed, it makes sense to have the right equipment to ensure the best sleep we can get. 

Picking the right mattress is essential to a good snooze. In a study conducted on men, it was shown that for men experiencing lower back pain, a firm bed is preferred. However, the build of a body is also important when picking the right mattress. For example, for a wide framed male, only the shoulders and pelvis will receive adequate support on a firm bed. Regardless, when it came to back pain, a firm bed was the better choice. In a perfect world, if everyone had an individualised mattress, a lot of problems would be solved, however for those who share a bed, there would be some obvious foreseeable problems.

In terms of pillows, you can purchase a memory foam pillow which will help manipulate your body to maintain a position. This is a wise investment if you’re trying to correct a poor postural habit while you sleep. 

If you wake up feeling a little stiff, after what has been a night of compromising sleeping positions, the best thing to counteract is with stretches to try and realign the spine. Stretches such as cat and cow will help to lengthen the spine as well as promote blood circulation around the body.  

Using a foam roller and tennis ball is another solution to relieve any sustained pain. A foam roller helps to release muscle tension and a tennis ball can be used for targeting specific areas of pain.  

For some people, the position they sleep in has little effect on their muscles, joints and bones the following day. However, as we age, our body is less able to mitigate the risks associated with certain sleeping positions. It’s best to seek the advice of a health professional before self-diagnosis. For instance, a chiropractor will be able to assess spine and neck alignment, as well as posture, and evaluate whether anything has been compromised. 

While the initiative of gaining more sleep is a step in the right direction, unless you know how to sleep you won’t be getting all the potential benefits. 

Fatouraee, N, Kashani, Y, Khodalotfi, M, Leilnahari, K & Sadeghein, M 2011, ‘Spine alignment in men during lateral sleep position: experimental study and modeling’, BioMedical Engineering OnLine, vol. 10, no. 103, doi: 10.1186/1475-925X-10-103


Dr Steven Lockstone has been a chiropractor for over 10 years. He has had three successful clinics in Melbourne and is currently based in Edgecliff, Sydney. For more information visit Dr Steven has also launched the HealthPro network ( which is Australia's largest private network of chiropractors.

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