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


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


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


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


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