North Shore Pediatrics
Educational Library


If you've ever woken up feeling like you were run over by a truck, you know that posture matters when you're sleeping too. Certain sleeping positions can intensify a swayback or give you a pain in the neck. Considering that you spend about a third of your life sleeping, your position can make a big difference in your overall posture as well as the comfort of your nights and mornings.

Most people who get an aching back while sleeping assume the problem is their mattress. Unless the mattress is lumpy or sags one way or the other, it doesn't matter as much as the position in which you sleep. The most important thing is to keep your head level with your spine. Often the solution is a few well-placed pillows. Proper support of the body can take a lot of stress off the joints of the spine.

Sleeping on Your Side
The side is a good sleeping position, but it creates the widest gap between your neck and the mattress. Side sleepers need a firm pillow that provides lots of support for the neck. Foam pillows give more support than cushy down ones. The pillow or pillows should be as wide as the distance from your ear to the end or your shoulder. If the pillows aren't high enough, your head will tilt down toward the mattress and your shoulder will really roll under - not good if you already tend to have rounded shoulders. Your pillow has to be wide enough to support your head and keep it in neutral (that is, level with your spine), but not so wide that it tilts your head toward the ceiling. Ask your significant other or a friend to check your sleeping position.

When you lie on your side with your knees stacked on top of one another, the weight of the top thigh pulls on the joints in the lower spine and the hip socket. You can take the pressure off by placing a regular-size bed pillow between your knees and lower legs. You'll find this extremely comfortable, especially if you have lower back or hip discomfort. If you roll to your other side during the night, your body will soon learn to take the pillow along.

Sleeping on Your Back
Back sleepers should put a pillow or rolled-up beach towel under their lower legs. When the lower legs are elevated, the lower back is in a more stretched position, which takes pressure off the spinal joints. Because of the way the leg bone fits into the hip socket, when you lie down with your legs straight out, the curve in the lower back is accentuated. This puts pressure on spinal nerves, soft tissue, and joints. You could wake up with a very sore, stiff back. If your head tends to hang forward, the last thing you want to do is sleep with two or three pillows lifting your head beyond your shoulders all night.

Your neck should stay in a neutral position, level with your spine. When you're lying on your back, your face should be parallel to the ceiling. Your head should not be pushed forward or allowed to roll back, making the neck too arched and the chin jut forward.

The goal is to sleep with one thin, flat pillow that allows correct alignment. If you are used to sleeping on your back with several pillows, take one pillow away at a time so you can gradually get used to the new height.

Sleeping on Your Stomach
Sleeping on your stomach can be extremely hard on your neck and lower back. You have to turn your head to one side or the other, which puts a lot of pressure on the neck. Stomach sleeping allows the lower back to sag into the mattress.

If you are one of those people who can only sleep on their stomach, place a small pillow or rolled-up towel under your abdomen to prevent the lower back from sagging down. For even greater back relief, sleep with one knee bent toward your chest. Make sure the pillow under your head is as flat as possible so your neck doesn't have to arch as well as twist to one side.

Buying a Mattress
You need a new mattress if one or more of the following is true.

  • Your current mattress is more than ten years old and hasn't been flipped or turned every couple of months.
  • Your mattress has lumps or it sags into the middle.
  • You can feel the springs or coils.
  • You continually wake up with a sore, stiff back or neck.
  • You roll into your partner during the night.

When you're buying a mattress, don't be shy - lie down on the models you're considering and stay in your most common sleep position for at least fifteen minutes. Select a mattress that is comfortable for you. Firm mattresses usually support the spine better, but whether the mattress is extra firm, firm, or medium soft is a matter of personal preference. A mattress that is too soft will let your body sag, causing you to wake up with aches and pains. Going from a soft mattress to a firm one will take some getting used to, and your back may be sore for the first week. Soon your body will get used to it, however, and in the long run your spine will be better supported while you sleep. If your current mattress is too soft, but otherwise still good, you can add support by placing a three-quarters-of-an-inch-thick piece of plywood between the mattress and box spring.

Pillow Talk
There are many kinds of pillows on the market today - rolls in all different shapes and sizes, contoured pillows, pillows stuffed with down and synthetics. Your pillow's job is to keep your neck in neutral and your head level with your spine. It should not push your head forward, allow your neck to arch, or tilt your head to the left or right.

  • Side sleepers need firm pillows to fill the wide gap between the neck and mattress.
  • Back sleepers need soft pillows that allow the head to sink in so it's not pushed too far forward.
  • Stomach sleepers need a thin, flat pillow or no pillow at all.
  • Contoured pillows are especially designed to support the neck whether you sleep on your back or your side. They have an indentation in the middle so the head is not pushed forward. They are raised on the ends, to support the neck if the person rolls onto either side. If you tend to change position during the night, a contoured pillow is a good choice.
  • If you rest, read, or watch TV in bed, you don't want to thrust your head forward. Instead stack up the pillows to raise your torso from the waist.

Helpful Hint
Statistics say we move every eleven minutes during sleep. My hunch is if we are moving that much, it is because our joints are uncomfortable.

Mattress toppers help with sleeping comfort by making your joints more comfortable. They help distribute your pressure points - points of contact with the mattress - more evenly and can take a considerable amount of pressure off your joints. A few strategically placed pillows and a good mattress topper can make a world of difference in joint comfort.

The least expensive type of mattress topper is the one that resembles the inside of an egg crate. It has a series of raised, foam ridges that distribute the pressure on body parts more evenly, allow for better circulation, and keep you cooler by allowing air to pass below you. There are many high tech mattress toppers available now for considerably more money. Some are made of feathers, some of lambskin, and some of memory foam.

» Return to table of contents «

North Shore Pediatrics, PC  -  480 Maple Street, Suite 3A, Danvers, MA 01923
Telephone 978.406.4234  -  Fax 978.921.2968

copyright © 2014 North Shore Pediatrics, PC All Rights Reserved