Most people know that sleep is crucial for the body’s recovery and wellness, but can it help alleviate the sore muscles caused by a day of bad posture. Or, do you sometimes wake up with worse aches and pains than when you went to bed? Your sleep posture might be the issue.
Posture is defined as the position of your musculoskeletal system that includes your bones, muscles, joints and other tissues. These provide stability and movement to your body throughout the day, whether dynamic posture (walking, running, or jumping) or static posture (sitting, standing, or resting). When you’ve been hunched over at a desk all day, for example, pain or stiffness in your muscles and joints could indicate poor posture.
Good posture extends to your nighttime rest as well as your daytime activities, so pain upon waking could suggest poor sleep posture. Pain during sleep is also correlated with sleep disruption, which may reduce your recovery and increase your symptoms of sleep deficiency. Not everybody has the exact same needs, but quality sleep is important for the short and long-term wellness of every individual. By practicing an improved sleep posture, you might find improvements in both acute and chronic musculoskeletal pain.
Sleep posture is highly related to sleep quality, and poor daily posture is linked to pain in areas such as the back, shoulders and neck. Poor daily posture creates increased biomechanical stress on the body, which can have significant short and long-term effects. Studies show that lumbar and cervical pain are the leading causes of musculoskeletal disabilities across most demographics and that proper sleep posture may reduce the risk of spinal pain.
Short-term effects include:
Long-term effects include:
Supine, side-lying and prone are the most common sleep positions, and they each impact the load and alignment of the spine differently.
Supine refers to lying with the face and torso facing up. Some sleepers in this position will vary posture by adjusting the position of their hands, arms, and legs. The supine posture is associated with lower back pain but not with neck or shoulder pain. Asymmetrical posture of the limbs could cause increased spinal load and lead to pain, however.
Side-lying or lateral posture is when you sleep on either of your sides. Some variations include supported lateral sleeping with your arm under your head or ¾ side-lying. If sleepers use this posture asymmetrically, or in other words, if they favor one side significantly more than the other, then they may experience some pain. Symmetrical side sleeping, however, is found by studies to be the least likely posture to provoke pain symptoms.
Prone posture refers to sleeping with the belly facing down and with the head facing one side or the other. This position is known to increase the load on the spine and is correlated with reduced recovery and provoked pain symptoms.
To reduce spinal or shoulder pain symptoms, you may need to either change your posture entirely or adjust your existing posture. The best sleep posture is whichever best maintains the alignment of your spine while reducing your individual pain symptoms.
Cervical or neck pain can lead to headaches and chronic cervical pain. The prone posture is most correlated with neck pain as it requires you to sleep with your neck twisted and misaligned with the rest of your spine, while supine or side-lying are most associated with reduced symptoms. If you sleep supine, try a rounded pillow to support your neck and a flatter pillow to cushion your head. Feather pillows or memory foam are good options to better conform to the shape of your neck. For side-lying, use a pillow that elevates your head adequately to keep your spine aligned.
If you experience pain in your mid or low back, then supine may not be a good posture choice for you. Instead, try side-sleeping with a small pillow positioned between your knees to even out your pelvis. To maintain spinal alignment in prone posture, place a small and flat pillow beneath your lower belly or hips, as well as under the feet.
Poor sleep posture can lead to compression in the occipital nerves, which are located in the scapular or trapezius areas of the upper back and into the neck. You may experience sensory symptoms such as tingling, pain, or numbness, as well as motor symptoms like weakness or partial paralysis. Symmetrical side-lying generally improves these symptoms. Try using pillows between your knees and under your head to maintain your spinal alignment.
Pain or tendinopathy in the shoulder joints may be aggravated by increased loading on the shoulders. Because you are weighting your shoulder in the side-lying position, it can be associated with increased symptoms. If you must sleep in this position, try additional pillows to support your arms and reduce loading on your shoulders. Otherwise, lying prone with your head to the side or supine with your arms outstretched to either side of your head are most highly correlated to reduce pain symptoms.
Just as your daytime posture can lead to chronic and acute pain, so too can sleep posture. By addressing your individual pain symptoms and adjusting your sleep posture accordingly, you might improve your sleep quality and make that first step out of bed in the morning more pleasant.
© 2021 American Sleep Association.