What is best sleep position
What is the best sleeping position?
hi I'm Kevin Wade I'm a senior therapist
at the st. John Clark pain treatment
center and on the campus director at the
Center for neuro some addict studies
both of our organizations are a bunch of
very passionate people trying to educate
you about neuro somatic therapy and the
benefits to you and your health and your
pain and and anything else we can bring
to you today I'm gonna have a little
discussion with you about sleeping one
of my favorite things in the world to do
but really honestly it's not the
favorite thing of a lot of people
because they're uncomfortable when they
sleep one of the questions we get asked
most often in the clinic is you know
what about my bed what about my pillow
what about my sleeping position it's
actually one of the questions we asked
on our intake form what position do you
usually sleep in and so there we believe
there are some things that are that are
really important about sleeping position
and I'm gonna share with you today what
we feel at the clinic are the two best
positions to sleep and kind of your
basic sleeping positions and I'm going
to share one with you that is not so
good for anybody so without further ado
I'm gonna get a couple of examples up
here and we'll take a look at these
positions okay so let's start with how
not to sleep I'm gonna go out on a limb
and say pretty universally stomach
sleeping is a bad idea for everybody and
here's why most people sleep on their
stomach with a pillow
sometimes flat on the on the bed but
that's even not that much better so what
we're doing is we're putting the spine
into a little bit of an extension and
tightening down all of these muscles
that are coming down the back along with
that we can see that Lexi here has her
head turned to the side and if we're
going to sleep on our stomach we have to
turn our head to the side that puts our
cervical spine into a rotation into a
twist and then we stay there for hours
and hours when we're sleeping the other
thing that we end up seeing with stomach
sleepers - again depending on the
mattress and and the state of the
mattress is that the low back tends to
curve too much here - kind of sinks into
the bed and we end up getting some low
back issues there are variations of what
happened down here people with their
feet sometimes straight out sometimes
kicked
to the side here now we're putting the
hip into a shortened kind of position
and and very asymmetrical here as as
Lexi's trying to sleep the worst part of
this sleeping position is what happens
in the cervical spine and that's that
rotation in the clinic we treat Atlas
axis distortions mal positionings of
those structures by releasing the
muscles around them and when you're in
this twist and most people tend to turn
their head to the same side every time
they sleep on their stomach it's not
like they switch back and forth which
would make it better but it's still not
great so we get we start to develop
these rotations in the cervical spine
that tend to go to the same side all the
time we fix those up in treatment and
then our patient goes back home sleeps
on their stomach in that rotated
position and the the cervical spine goes
back into the distortion and the neck
pain that they usually exhibit with this
kind of sleeping pattern so I'm gonna
I'm gonna have at the end of this video
a little bit of a secret of how you
might change this position because most
people will say I love to sleep on my
stomach it's the only way that I can
sleep I've tried sleeping on my back
I've tried sticking be on my side and I
just can't do it well there's a little
bit of training we have to change some
neurological patterns in order for you
be able to get out of this position but
that's what we're all about anyway so
that's I'll show you a little trick to
help you get off of your stomach while
you're sleeping at the end of this video
so here we have a side sleeping position
Tony's on his side kind of with one
pillow here and nothing else now side
sleeping is is really an okay position
to sleep in although many people find it
to be uncomfortable if you have a
shoulder injury or shoulder pain that
could be problematic here too again we
run into folks with certain neck issues
and certain low back issues and I want
to show you how to make this side
sleeping position better more
comfortable and something that you can
do to help alleviate any any of those
discomforts that you have all right so
first of all we're gonna start down at
the bottom here there's a couple of
things missing what we want to do is
support the knees and the low back here
a little bit better and in doing that
I'm going to grab a pillow from here and
we're gonna use this one right
Queen the knees okay so many people like
to be stacked up as we call it the hips
one on top of the other the knees one on
top of the other right here and this is
a great position we don't want the knees
to be too bent like up in that crunched
up kind of fetal position because that
again will tighten things across the the
hips here overnight but a stacked knee
position with a pillow that goes from
the knee all the way down to the ankle
there are some products out there that
kind of only support maybe the the knee
but what happens here is then the foot
falls down towards the table put some
torque on the knee and possibly some
rotation in the hip so if you can manage
a pillow between the knees that covers
the whole lower leg supports the thigh
basically what we're going for is to
have this upper leg parallel to the
table right so we're in a nice kind of
even position here one above the other
now some people like to sleep with a
knee thrown out in front of the other so
in that position go ahead and straighten
out your back leg there okay
now this is this position actually
becomes pretty problematic for side
sleepers here we put a huge rotation
into the low back and often that ends up
being uncomfortable after a little while
and and we get some low back problems
here we need maybe something more
substantial a larger pillow or that I've
seen different yoga bolsters and things
like that that work well here we'll put
this thicker pillow out in front again
even this is not quite enough for Tony
so I'm just going to use an extra pillow
to show you the the position and we'll
put a lot of pillow right there again
we're gonna support all the way down to
the ankle so we don't get a rotation
here we're better the hips stay a little
stacked up again the thigh is parallel
to the table and we've got a good
untwisted supportive position here for
the lower half of the body now in this
once we've got that end taken care of we
need to take care of the torso as well
what ends up happening for a lot of site
sleepers is that this arm will come up
here will be all cuddly by the face and
then and then the torso will start to
roll down towards the the table like
that or the shoulders start to compress
in and we got a very collapsed chest
kind of situation going on so what we
can do is support that and I used my big
pillow down here and I need to use that
for Tony up front so let's go
to the stacked position here alright so
we get back to that that nice
comfortable position here so depending
on the size of a person's torso we might
need to use again a smaller pillar or
larger one this is a fairly large firmer
pillow and what we're gonna do is we're
gonna stick that right under the arm
have Tony hold on to that and it's just
kind of hug that pillow to the chest and
that actually helps to prevent that
rolling forward and the collapsing of
the the shoulder into this closed off
chest position here so now we've got two
pillows we have to manage this does
become a little bit of an issue when
you're trying to achieve a good sleeping
position but I'm gonna have you do
something Tony I want you to keep that
pillow between your knees and hold on to
that pillow that you're hugging and turn
over and lay on your other side okay
there we go
did you ever practice that before Tony
no no first time it was that easy okay
so what he's doing is just holding onto
the pillow with the knees and the pillow
at the chest and those pillows come
right with him as he turns over okay
let's do that again roll onto the other
side now the last little bit here that
we have to consider is what's happening
up at the at the head and the neck I'm
gonna move that down so we can see a
little bit better a lot of people have
an issue about what to do with this arm
straight out in front laying on the
mattress is fine I also find that if we
scoot this pillow a little bit that way
it could be bent and kind of in a curl
position you're right next to the pillow
the one position we try to get people to
avoid is putting the arm up under the
head this way it changes where the the
head is positioned for one thing and it
also puts a lot of strain on the joint
capsule here at the the shoulder but the
last thing we really want to look at
here is the position of the head itself
okay a pillow on the bed underneath the
head here should keep the cranium in
line with the spine all the way down if
the pillow is too shallow okay the head
will fall down towards the table and
then we get a flexion to the the to the
bed side or if the pillows too high we
get it in here nice and relaxed there
the head's going to head up towards the
ceiling and we're in the opposite
flexion and that is a problematic for
these lateral muscles of the neck
anything that could shorten up and
tighten
in in that respect this pillow that we
have right here is pretty good for Tony
he's got a nice straight line and and
the spine is very lined up here he's not
twisted in any kind of way and this is
what we would call a you know a very
stable very comfortable side lying
position so here we have a Lexi in a
side-lying position I just want to give
this as a little bit of an extension
from what we saw with Tony Tony's got a
very square torso
male hips narrower all of that with
Alexi here she's got a narrow waist and
wider hips and wider shoulders so what
happens in the sideline position is her
lumbar spine is going to kind of want to
fall down towards the table okay or
towards the mattress this is where we
get into a little discussion of
mattresses depending on how good the
support is in your mattress this may be
taken care of in a good mattress your
hips we'll think a little bit farther in
the shoulders I'll sink a little bit
farther in and the mattress kind of
arises to support this in a way but if
you if you can helps someone check this
out for you while you're lying in bed to
see if your spine does kind of curve
down towards the mattress like that
one of the things that we can do and I'm
going to just really quickly kind of
take this out and no slide a pillow and
I want you to just push up on your side
there we're gonna use a pillow here just
above the waist
and kind of fitting in the curve of the
hip there this pillow is just about
right to support Lexi in a nice straight
spine position yeah we may have even
gone a little too far with this pillow
but you can get the idea of what what
you can do to support the lumbar area
from curving down and going into the
table into a lateral flexion in the
sleeping position here we've got the
spine all the way from the sacrum coming
up through the cervical spine in a nice
straight line and that's what we're
looking for so it can be kind of hard to
see all of this or experience all of
this on your own you may have to enlist
the help of a partner to come and take a
look at you while you're lying down in
bed come and look at you from the back
this side looking right at the spine and
looking
that straight spine okay so this is how
we would achieve yet again another
nicely balanced side lying position
let's move on and do the back sleeping
position now so here we have Lexie in a
back sleeping position and this is your
typical back sleeping position that most
people get into completely flat on the
bed and a nice big fluffy pillow
underneath the head but what we can see
there's a big problem with this right
off the bat is that this nice big fluffy
pillow has pushed Alexi into major head
forward position okay and this is what
happens - I would say most people when
they're trying to sleep on their back
you get these big down pillows and
they're they're not appropriate for your
body size they're not appropriate for
the position that your head needs to be
in alright one of the alignment kind of
guidelines that we use is actually this
chart right behind me the Bayesian
skeletal chart to look at proper
alignment from the side go ahead and
drop your your head down here if we look
at the the alignment of the body from
this midline right here on the side and
we look at the torso and the head I'm
just going to show you a Lexie shoulder
here the middle of the shoulder joint
should line up with the middle of the
ear right about here okay this is good
alignment from front to back when we get
too far out in front of our shoulders
there's other points to align here as
well the head becomes in this head
forward we tighten up all of these
muscles along the front side of the neck
and that can even start to involve
muscles down at the chest and and we get
this rounded forward head forward neck
pain shoulder plane kind of situations
so for Alexi she actually looks like
she's in really good alignment they're
flat on the bed
however there's there's really go ahead
and lay back here there's nothing
supporting the back of her neck okay now
this is can be a problem for people as
well who find that this flat position
works better but don't support
themselves here what ends up happening
over time is the head will start to go
into annexed position and the neck
starts to press down towards the table
and then we get a straightened cervical
spine so what we want to do is find
something like a
a roll a neck roll some people use a
towel rolled up and you can find a towel
that's just the perfect that kind of
diameter there this pillow is a three
and a half inches in it it might be just
about right for Alexi let's check it out
come back down here and I'm gonna slide
it over a little bit so we can see a
little bit better there we go come on
down there
so this is maybe just a little bit too
much support here I'm guessing that the
Alexi feels a little bit too much
pressure on the back of her neck
something just smaller a little bit
smaller than this but the head is
actually resting on the mattress the
neck is supported and the ear is in line
with the shoulder which is where we want
it for this kind of coronal plane
alignment alright so going from there
there's a couple of other things that we
might want to do if there is a patient
with a low back problem especially if
the low back tends to curve too much we
might want to support underneath the
knees okay so we can just use a regular
pillow here and place the knees over
that way this is probably the
orthopedically
musculoskeletal kind of most neutral
position to sleep in and and the one we
recommend to most of our patients one
caution the only situation where I
really would not recommend back sleeping
is if you suffer from sleep apnea or
have you know significant snoring
problems usually a side sleeping
position is better for those conditions
okay so I want to just give you one more
example of back sleeping so let's switch
Tony in here for Alexi so I've just
switched Tony in here just it to make
the point about the alignment up at the
neck here very different body shape
Tony's very thick through the the torso
so that means a little bit more support
under the head a little bit more pillow
is appropriate this is this is pretty
close to right for Tony here the the
shoulder and the ear are in a good
position you know if if there's a slight
movement forward of the head and past
the shoulder it's not a big deal but we
really just don't want that to go too
much past where the shoulder is aligned
here to here so this is again
just the point that we have to take into
account our body shapes our size all of
that when we're finding the best
position sleep in in bed and here too
I'll come back to the mattress again if
you have a softer mattress you need less
pillow under your head because your
body's gonna sink into the mattress
which in effect makes that pillow push
your head more forward okay so if you
like a softer mattress really consider
what you're using for pillows because
you're gonna you're gonna sink into that
mattress a firmer mattress you'll stay
up more on top of that and more pillow
would be appropriate okay now I said I
was gonna have a secret for you to keep
you from wanting to sleep on your
stomach let me just go out of the camera
here and grab one thing real quick
now this little method was taught to me
about 20 years ago actually by a
chiropractor your if you you want to
break this habit of sleeping on your
stomach we're gonna use a little bit of
aversion therapy okay it's it may be a
little unpleasant but that's the point
what we're gonna do is get an old
t-shirt a tennis ball or some other
let's say non sharp object we don't want
to cause any damage here and a roll of
duct tape okay you're gonna place the
the ball in the middle of your chest
you're gonna duct tape that ball to your
old t-shirt all the way around strap it
on there so it doesn't move and then
when you try to go lay on your stomach
you're gonna press into that it's going
to be uncomfortable and it will in your
half sleep kind of tell you to get off
of your stomach and and into your side
sleeping or back sleeping position that
tends to work good with a tennis ball a
hairbrush I don't know your cat's
something but but stick that right on
your chest so that when you try to roll
onto your stomach you can't a couple of
other strategies that that are maybe a
little less version wise a nice big
pillow that is actually fairly long here
can under your knees can keep you in a
back sleeping position because as you
try to roll over the pillow will feel
uncomfortable under your knees all right
that's that's another way some of our
patients have been successful with
stuffing pillows on either side of them
so that there's something physically
there that they feel like they they
don't want to move out of this position
others back people sleeping position and
onto their stomach so there's a few tips
for you about what you can do to kind
get yourself out of that stomach
sleeping position those are the
positions that we try to recommend to
our patients as we're working through
pain issues with them as we're trying to
get them in good alignment we find that
that the sleeping position is really
pretty vital in most cases and kind of
putting people into a healthy position
while they're asleep
just like we try to put them in a
healthy position while they're standing
or sitting is really really key in
getting the whole picture here of health
and happiness and being pain-free
so thank you for your attention today if
you have any questions about your
sleeping position or your pillow or your
mattress this month at the clinic is our
sleep month a very very important issue
you can come on in and see us we'll get
do an evaluation for you of your
sleeping position and the pillows that
you're using thanks very much come see
us at the st. John Clark pain treatment
center
