Position Matters! Sleep Optimally

We frequently have patients asking what they can do at home to help them hold their adjustments. Amongst other things, picking an appropriate sleeping position is extremely important, especially since many patients experience secondary conditions such as neck discomfort after “sleeping funny”.

So what’s the best sleeping position? As you may know, there are three main sleeping positions- stomach sleeping, side lying, and back sleeping. Let’s take a closer look at each.

Stomach Sleeping

Most of you have heard us say that this is the least desirable sleeping position. Unless you have a specialized pillow which allows you to lie face down while sleeping, the only way to comfortably breathe while stomach sleeping is by turning your head to one side. This can put abnormal stress and tension on your spinal cord, and can result in a tonal shift (or misalignment) within the spine.

Even if you do have a specialized pillow for stomach sleeping, this position is still unfavorable. These special pillows are generally wedge-shaped to allow extra space for your nose and chin while lying face down.  Sounds great in theory, but this added wedge places your spine into hyperextension, causing tension on your spinal cord. Because a neutral spine is best when choosing a sleeping position, again, stomach sleeping is not recommended.

Side Lying

Sleeping in a side-lying position is one of the easiest ways to create a neutral position for the entire spine. However, there is one key component that makes this statement true- the proper pillow height. What pillow do we recommend?  Sorry to disappoint you, but there’s no one pillow that works for everyone. Keep in mind our bodies are all different- the broadness of our shoulders, head width and arm musculature are all different and all affect which pillow is best to use. With that being said, we are more concerned with the ability of a pillow to create a neutral spine than what brand it is or what material it is made of.

Side Lying2As the picture depicts, it is important to choose a pillow the supports the head in a way that creates a neutral spine. When looking at someone from behind, we want to be able to draw a horizontal line down the entire length of the spine, without any bumps or tilts. A pillow that is too flat or even too full can prevent achieving that neutral spine. Don’t be afraid to try the pillow out before you buy it!

One last piece of advice about side lying- to help maintain a neutral pelvis, try placing a pillow between your (preferably bent) knees.

Back Sleeping

Back sleeping is another position easy for keeping a neutral spine, but again, the proper pillow must be used. To maintain the normal curve of the neck, it is important to choose a flat pillow if you are a back sleeper. A fuller pillow could cause the chin to tuck towards the chest, increasing the tension of the spinal cord.

How can choosing the right pillow affect my low back?

There’s a big emphasis on proper positioning of the head while sleeping by using the correct pillow. It is easy to draw a correlation between improper head alignment and neck pain, but how can that affect your low back? Great question!

It’s important to remember that the spinal cord attaches at the very top and very bottom of the spine. Those spinal segments directly affect the tone or tension of the spinal cord, and when the spine is in its proper alignment, the tone of the spinal cord is ideal. Let’s say you have been sleeping incorrectly, and as a result, you experience a tonal shift in your neck. There is now an increase in the tone/tension of the spinal cord. Sometimes secondary conditions are felt in the areas of those tonal shifts, so in this example, in your neck. However because there is increased tension throughout the entire spinal cord, you may actually feel secondary conditions in the low back. Remember we said that the spinal cord attaches at the very top and the very bottom of the spine, so a tonal shift in the neck may create tension or “pulling” in the low back, leading to low back pain.


Sleep is essential for our bodies and can specifically affect mood, healing, and energy levels. Make the most of it by correcting your sleeping position- you may experience better sleep, and equally as important, reduce spinal subluxations!