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What's the best position to sleep in?

This is a question we often get asked by patients. Getting a good night’s sleep takes priority, so sleep in whatever position to allow you to sleep. But here are a few tips that will help you wake up without a sore neck or back.

Neutral position – 

Understanding what position your head and neck should be in will help you choose the right pillow for you. The optimal head position whether you are sitting, standing or laying down is when your head is positioned centered on the body facing forward. It should not be tipped, rotated or pushed too far forward/backwards. Keeping the shoulders in line with the hips should help prevent excessive rotation in the spine This helps minimize the stress on the muscles, tendons and ligaments in the neck.

Pillows –

You want a pillow that will support the head and the natural curve of your neck. For this you need a pillow that is firm enough to support the head, but flexible enough to support the curve of the neck. Some pillows are designed specifically for laying on your back, or side lying. A quality pillow should be able to bounce back after being folded in half, an older pillow will not.


Waterbase, feather or synthetic pillows that mimic feather pillows are easy to reshape; making it easy to adjust them to different sleeping positions. Memory foam pillows do a good job of supporting the head while you lay on your back, but are often too firm to support the neck in sidelying.

Laying positions –

It’s easiest to maintain a neutral position and support the head/neck when laying on your back; placing a pillow underneath the knees often helps with low back pain.

When laying on your side make sure the pillow is supporting your neck as well as your head; and it recommended to place a pillow in between the knees to help maintain hip alignment. Depending on how firm your bed is, it helps to place towels in any areas of the spine that sagging downwards.

Unfortunately laying on your stomach is not recommended since it is very difficult to maintain a neutral spine because you have to turn your head to breathe. You can place a pillow on the forehead to allow for room to breathe, but then your neck is not supported from below and may have too large a curve. If you have lots of pillows you do have options though! The semi-side lying position is a great alternative to laying on your stomach. You lay at a slant, but support yourself with pillows to keep the shoulders and hips in alignment.

So get some extra pillows and hopefully these tips can help!

– Dan Barnes, PTA

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