Amanda Schupak
Ever wake up with a crick in your neck or a pain in your lower back? Are you roused from sleep by heartburn, or a partner complaining that you snore?
If you answered “yes” to any of these questions, your sleep position might be to blame.
There is no one “right” way to sleep, says Dr Indira Gurubhagavatula, a professor of sleep medicine at the University of Pennsylvania Perelman School of Medicine.
But if you are waking up with discomfort or stiffness or having restless nights, certain adjustments to your sleeping posture may help. Here are some of the most common issues associated with how people sleep, and what to do about them.
On your side
Many of us sleep on our sides with no problem. But for some people – especially those with joint issues or who are older – it can put a lot of pressure on the shoulder, hip and knees, says Dr Rohan Jotwani, a pain medicine specialist at NewYork-Presbyterian/Weill Cornell Medical Centre in New York City.
Sleeping on top of a memory foam or gel mattress pad can help by distributing your weight more evenly, he says. Placing a pillow between your knees can also reduce hip, knee and lower back pain by keeping your legs and hips aligned.
When you’re on your side, using a pillow that is either too thick or too thin can force your spine out of alignment, leading to muscle and joint strain. Or it can put pressure on nerves, causing pain, tingling or weakness in your shoulders, arms or upper back, Gurubhagavatula says.
Those who have a deviated septum may find that sleeping on their side affects how well they breathe, says Dr Gerald Suh, an ear, nose, throat and sleep specialist in Princeton, New Jersey. The condition occurs when the thin layer of cartilage and bone that divides the nasal cavity is off-centre or crooked. It is common, he says, affecting probably more than 80 per cent of people, though only about 30 per cent notice an influence on breathing.
For some, it’s easier to breathe when they sleep on the side that the narrower nostril is on, allowing air to flow unimpeded through the wider one, Suh says.
On your back
The goal when sleeping is to maintain the natural curvature of the spine and neck “without creating too many bends and twists and turns,” Jotwani says. Sleeping on your back is best for maintaining this alignment, he says, but it can also cause or exacerbate other issues.
The symptoms of obstructive sleep apnoea, for instance – which occurs when the muscles in the throat relax during sleep and cause snoring and temporary pauses in breathing – can worsen when lying face up, says Azadeh Yadollahi, a scientist who studies sleep and airway disorders at the University Health Network in Toronto.
If you have sleep apnoea, sleeping on your side can help keep the airway open and let you breathe more freely, Gurubhagavatula says.
Sleeping on your back may also worsen acid reflux symptoms by allowing stomach acid to seep into the esophagus. And while any sleeping position can lead to nasal congestion, lying face up can cause you to feel even more stuffy, especially when dealing with a cold or allergies, Suh says.
Propping up the top half of your body with a pillow or a wedge-shaped bolster helps relieve acid reflux, Gurubhagavatula says. Or try elevating the head of your bed by putting blocks under the legs of your bed frame, she says. Some research also suggests that sleeping on your left side can help, too.
Pregnant women are often told to avoid sleeping on their backs after about 20 weeks to prevent the uterus from putting pressure on a large vein that carries blood from the lower body to the heart. That could restrict blood flow to vital organs or lower blood pressure, leading to lightheadedness.
When pregnant, it’s safest to sleep on your side, especially the left side, as this moves the weight off the vein, Gurubhagavatula says. This should help with pregnancy-related acid reflux, too, she adds.
On your stomach
This is the least common sleeping position, Gurubhagavatula says. It also tends to be the hardest on your spine.
Having your head turned to one side all night strains the neck, Jotwani says. And that can be compounded by a thick pillow that angles your neck upward.
The position can also hyperextend your lower back. In a review published in 2025, researchers found that sleeping on the stomach is associated with more lower back pain than sleeping on the back or side.
If you enjoy sleeping on your stomach but wake up with low back pain, it can help to put a small pillow under your pelvis. This prevents your abdomen from sinking into the mattress and putting too much arch in your back, Jotwani says. But if possible, he adds, sleep on your back or side for better alignment.
How to learn to sleep in a different position
Switching to a new position “can be very daunting,” Jotwani says. He recommends identifying a new position and then trying to spend at least a little time in it each night. Over time, your body will get used to it.
Strategic placement of pillows, special cushions or devices can help keep you in one position throughout the night, Gurubhagavatula says. To stay on your side, try placing a body pillow behind you, she suggests. There are also cushions that strap onto your back to keep you on your side, and electronic devices that vibrate when they sense that you’ve rolled onto your back. They’re the technological equivalent of getting elbowed by your bed partner, Yadollahi says.
If you’re new to sleeping on your back, Gurubhagavatula says you might be more comfortable with a small pillow under your knees, even if it feels awkward for the first few nights.
Your sleep position is just one of many factors that contributes to your overall sleep quality, Gurubhagavatula says. Maintaining a consistent sleep schedule, getting adequate exercise and keeping your bedroom dark and cool are all important.
But, she adds, if getting a good night’s sleep can be “as simple as turning onto your side, then why not try it?“
The New York Times
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