The Best (and Worst) Sleeping Positions and Why

By Dr Ernst
December 5, 2016

Sleep is essential, just like air, water and food. More than 75% of Americans admit they don’t sleep well, and the position you sleep in could have something to do with that. Your brain is MORE active when you are sleeping than when you’re awake, and its been recently discovered that sleeping is when your body heals most efficiently. If you’re like most, you have a “favorite” position -so lets see what the best (and worst) sleeping positions are for your health.


While this is generally regarded as the best sleeping position, too many of us sabotage this position with pillows, or don’t give ourselves the opportunity to enjoy the health benefits due to the inability to maintain this position (usually because of pain, apnea or snoring).

When you sleep on your back, your spine remains neutral in both planes and your spinal discs begin to decompress from the effects of gravity. It’s best to use no pillow at all and place a 3” foam support under your neck and a 2” foam support under your low back. This helps to maintain the natural arch to your spine, supporting normal neurological function.


This position also allows for your spine to stay in a slightly neutral position, however, it must be done properly to be considered safe. When side sleeping, gravity has a tendency to distort the anterior plane of the spine, producing micro scoliosis while sleeping. This is enhanced when you do not have a properly sized pillow for side sleeping.

If side sleeping, measure the distance between your shoulder tip and neck and make sure your pillow is the same size. For example, the average adult requires a pillow that is 5-6” thick, almost twice the size of most pillow on the market today. Most side sleepers admit to putting their hand/arm under the pillow which can cause neurological compression as it elevates the pillow and your head/neck.

Side sleeping also requires the use off a “leg” pillow to help decompress gravity’s effects on the hips/pelvis from the superior knee/leg. While some companies make a specific “leg pillow,” placing a traditional sleeping pillow between your knees will work. Failure to do this allows gravity to pull the hip forward or backward based on the placement of the leg/knee.


Fetal sleeping is the same position as side sleeping, but with the knees drawn towards the chest, arms tucked in and the spine carved in an anterior flexion position. This is believed to be the most popular side sleeping position as it brings back memories of comfort and safety from childhood. The issue here is that constant bending of the knees and arms decrease blood and lymphatic drainage and has been linked to an increased chance of arthritis and or morning stiffness. Additionally, the forward flexion (or rounding of the spine) causes physical compression of the lungs by the ribs, decreasing oxygenation.


It doesn’t take much to realize why this is the worst position for healthy sleeping. In order to breathe, you have to turn your head either right or left, which causes a rotational extension effect to the cervical spine that closes the nerve channels in your neck as much as 60%, according to a study by the American Chiropractic Association. Stomach sleeping also places torsion force on the mid and lower back due to the neck being rotated to breathe. Additionally, during stomach sleeping the lungs and heart are compressed by the gravitational push of your spine and ribs against the soft organs decreasing their function. According to, stomach sleeping also decreases your ability to breathe and oxygenate the body because of the additional force it takes to inflate the lungs and elevate the weight of your body.

Retraining Your Sleeping Pattern

Now that you know the “best and worst” sleeping positions, it’s time to upgrade.

Tips: To begin, I suggest moving up one level. If you’re a stomach sleeper, try fetal or side sleeping. If you’re a side sleeper, it’s time to start sleeping on your back! If you’re the type of person who says, “I can’t do that” or “I cant sleep that way,” then you are right! Remember Henry Ford’s quote: “If you think you can or can’t, you are right!”

The most common reason for resistance to upgrading your sleeping pattern: IT HURTS TO SLEEP THAT WAY. It’s time to find out why versus letting your current sleeping position act like a coverup to your problems. Remember, back sleeping is not only the healthiest, its also the most NORMAL WAY TO SLEEP.

If you have pain when you sleep on your back, it’s usually because your spine isn’t decompressing from the effects of gravity as it should – usually due to restriction (subluxation) of normal movement, arthritis or a loss of curvature in your neck or back.

Bonus for those having trouble sleeping 

In addition to upgrading your sleeping position, you can do the following things to help you fall asleep, and stay asleep:

  1. Remove any and all electronic or light-emitting devices from your bedroom.
  2. Install “blackout shades” and do everything within your power to remove any and all light from entering your bedroom. (An alternative is to use a “Sleeping Mask.”)
  3. Keep your room between 60-68F. Several recent studies are hinting that this is the best temperature for natural sleeping as your body cools naturally when you are asleep. Because this can be difficult to obtain with your whole house system, consider installing a window or room unit.
  4. Take a 60-90 min hot epsom salt/lavender oil bath prior to sleeping. Use 1-2 cups of epsom salts with 10-15 drops of lavender oil in as hot-as-you-can-stand-it water.
  5. Get adjusted. One of the best “side effects” of releasing the stress in your spine is better sleep!
  6. Sleep/Mood Formula: For those of you who have done all above and still struggle, consider trying our “Sleep/Mood Formula” a blend of natural sleep herbs which help to stimulate the sleep centers of your brain prior to sleeping.



headshotDr. Aaron Ernst, D.C. is host of News Talk 1110 WBT’s “AskDrErnst” show and clinic director of Maximized Living Charlotte.

He specializes in providing customized nutritional and detoxification total body healing programs, utilizing the 5 Essentials of Maximized Living.

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