What Your Sleeping Position Says About Your Spine
- Dr Tommy-Lee McCafferty DC
- 5 days ago
- 4 min read
Your sleeping position can influence how your spine feels, moves, and functions throughout the day. The way you lie at night can affect the natural curves of your spine, how your joints are loaded, and the quality of your rest. Poor sleep posture may contribute to discomfort on waking, while a well-supported position can support more comfortable movement and general wellbeing. This article explores common sleeping positions, what the current research says, and how small, practical adjustments may help you wake up feeling more refreshed.
Why Sleep Posture Matters
We spend around one-third of our lives asleep, and during this time our bodies carry out essential repair, restoration, and neurological processing (Walker, 2017). When the spine is poorly supported at night, it can lead to unnecessary strain on the surrounding muscles and joints. Over time, this may contribute to stiffness or discomfort for some individuals.
Research has shown links between sleep posture, musculoskeletal loading, and persistent pain (Gordon & Grimmer-Somers, 2011).
Your sleep position can influence:
The natural curves and alignment of the spine
Pressure through the hips, shoulders, and lower back
Breathing, circulation, and quality of rest
How refreshed or stiff you feel upon waking
Recognising your sleep habits - and understanding how they affect your body - can help you make small changes that benefit your comfort and recovery.
The Best and Worst Sleeping Positions for Spinal Comfort
1. Sleeping on Your Back – A Supportive, Balanced Choice
Sleeping on your back helps the spine remain in a neutral position, which can reduce unnecessary strain through the joints and supporting muscles. This position may also help distribute weight more effectively across the body.
Pros:
✔ Supports natural spinal alignment
✔ Reduces localised pressure
✔ May help with acid reflux when slightly elevated
Cons:
✘ May increase snoring or worsen sleep apnoea for some people
What the research says:A study published in The Spine Journal found that lying on the back can reduce spinal loading and muscle activity compared with side or stomach sleeping (Viggiani & Callaghan, 2018).
Best practice tip:Place a small pillow under your knees to support the natural curve in your lower back.
2. Side Sleeping – A Good Choice for Lower Back Relief
Side sleeping is the most common position and can feel particularly supportive for those experiencing lower back or hip discomfort. It allows the spine to remain relatively aligned while reducing pressure through the lower back.
Pros:
✔ Supports the body’s natural curves
✔ May reduce pressure on the lower back
✔ Often recommended for sleep apnoea or acid reflux
Cons:
✘ Can create pressure on the shoulder or hip
✘ May contribute to facial creasing
What the research says: Studies suggest that side sleeping can improve circulation and may reduce lower back discomfort in some individuals (De Koninck et al., 1992). It may also support cerebrospinal fluid movement, which plays a role in neurological recovery during sleep (Xie et al., 2013).
Best practice tip:Use a pillow between the knees to keep the hips level and help prevent lower back strain.
3. Sleeping on Your Stomach – The Toughest on the Spine
Stomach sleeping places the neck in rotation and the lower back into extension, which may increase strain on these areas over time.
Pros:
✔ May help reduce snoring for some individuals
Cons:
✘ Increases pressure on the lower back
✘ Encourages twisting through the neck
✘ Can contribute to discomfort and stiffness on waking
What the research says:Research in Physical Therapy found that prone sleeping increases lumbar extension and cervical rotation, potentially contributing to discomfort in some people (Kuo et al., 2015).
Best practice tip:If stomach sleeping is your preferred position, placing a thin pillow under the pelvis may help reduce strain.
How to Improve Your Sleep Posture
Small, thoughtful adjustments can help support your spine more effectively overnight:
Choose the right pillow, a supportive pillow should help keep the neck in a relaxed, neutral position. If your head is lifted too high or drops too low, the neck may feel strained on waking.
Select a mattress that meets your needsResearch suggests that medium-firm mattresses can offer balanced support for spinal alignment (Radwan et al., 2015). The right choice will depend on factors such as body weight, preferred sleeping position, and comfort preferences.
Adjust gradually if neededChanging your sleep position can take time. Supporting your body with pillows can help guide a smoother transition.
Final Thoughts
Your sleeping position plays an important part in how your spine feels day to day. While there is no single “perfect” posture for everyone, small changes can make a meaningful difference to your comfort and quality of rest. At Connected Chiropractic, we encourage patients to consider both how they move and how they rest when thinking about spinal wellbeing.
If you regularly wake with stiffness, discomfort, or persistent tension, it may be helpful to review your sleep posture and book an assessment with one of our Doctors of Chiropractic. They can help identify any underlying issues and discuss personalised strategies to support your spinal health. Written by Dr Tommy-Lee McCafferty, Doctor of Chiropractic.
References
De Koninck, J., et al. (1992). Sleep positions and quality of sleep. Sleep Research
Journal.Gordon, S., & Grimmer-Somers, K. (2011). Sleep position and musculoskeletal pain.
Journal of Pain Research.Kuo, Y. L., et al. (2015). The effect of sleeping positions on spinal curvatures.
Physical Therapy.Radwan, A., et al. (2015). Effect of mattress design on spine alignment.
Applied Ergonomics.Viggiani, D., & Callaghan, J. P. (2018). Low back biomechanics in various sleeping postures.
The Spine Journal.Walker, M. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams.Xie, L., et al. (2013). Sleep drives metabolite clearance from the adult brain. Science.
