Most people never think twice about how they position themselves at night, but it turns out the way you sleep could be quietly working against your body. Since we spend roughly a third of our lives in bed, the cumulative stress placed on the spine and joints over time is anything but trivial. That built-up strain can lead to back pain, a stiff neck, and a whole range of musculoskeletal complaints. Issues like uneven pressure, muscle tension, and joint stress can even cause people to unconsciously slouch or hunch throughout the day.
Lisa Artis, Deputy CEO of the organization The Sleep Charity, spoke to Metro about the powerful connection between nighttime habits and daytime posture. “Sleep and posture are closely linked,” she explained, noting that the position we rest in can either support the spine’s natural curves or subject it to hours of unnecessary strain. She also pointed out that the surface we sleep on plays a major role, saying that “a mattress that’s too soft or too firm can throw spinal alignment off, while a pillow of the wrong height can put stress on the neck.” Still, the actual sleeping position itself matters just as much, and Artis broke down which ones help and which ones hurt.
When it comes to sleeping on your back, Artis considers it one of the better choices available. “Sleeping on the back allows the head, neck, and spine to rest in a neutral position, especially when using a supportive pillow,” she explained. Back sleeping helps distribute body weight more evenly and reduces pressure on any single area. That said, it can make snoring or sleep apnea worse because the tongue tends to fall backward, so a firmer mattress is generally recommended to prevent the body from sinking. A small pillow tucked under the knees can also help preserve the spine’s natural curve, though sleeping with arms raised overhead in what’s sometimes called the “starfish” position can put unnecessary strain on the shoulders and compress nerves.
Side sleeping is another solid option, according to Artis. It can keep the spine relatively straight while also reducing snoring and breathing difficulties, making it a go-to recommendation for pregnant women and people who deal with digestive issues, particularly on the left side. Some people do experience shoulder pressure or neck discomfort in this position, which a properly supportive pillow can usually address. Placing a pillow between the knees is also helpful for keeping the hips aligned. One variation to be mindful of is the fetal position, where the knees are pulled tightly toward the chest, as it can lead to excessive rounding in the upper back and is generally considered less beneficial than a neutral side-lying posture.
The clear loser among sleeping positions is stomach sleeping, which Artis describes as the most problematic for posture overall. She explained that this position “forces the neck to turn to one side and can flatten the natural curve of the lower back,” leaving the spine in an unnatural alignment for the entire night. “Over time, this can contribute to stiffness or discomfort after waking,” she added. For those who simply cannot break the habit, the advice is to either use an extremely thin pillow or skip it entirely, and to place a pillow beneath the pelvis to take some of the pressure off the lower back.
Beyond individual sleep positions, it is worth understanding the broader science of spinal health during sleep. The human spine has three natural curves: the cervical curve in the neck, the thoracic curve in the mid-back, and the lumbar curve in the lower back. Good sleep posture generally means these curves are supported and not flattened or exaggerated. Sleep experts and physical therapists widely agree that the ideal sleeping environment includes a medium-firm mattress for most people, as it provides both support and pressure relief. Pillow loft, meaning how thick or thin a pillow is, should be chosen based on sleep position since side sleepers typically need more height to keep the neck neutral, while back sleepers need less. Chronic poor sleep posture has been linked in research to conditions like cervicogenic headaches, which are headaches that originate from tension in the neck, as well as herniated discs and general chronic lower back pain. Sleep hygiene experts also note that consistency matters since regularly switching between very different positions each night can make it harder for the body to adapt and recover properly.
If you have strong opinions about your go-to sleeping position or have noticed a difference in how you feel based on how you sleep, share your thoughts in the comments.
