Is Side Sleeping the Best Position?
This is Part 3. Click here for Part 1 or Part 2.
Beds for Side Sleepers. Each sleeping position has its own benefits and disadvantages. For side sleepers and the others, the bed and pillows can mitigate the disadvantages for a better night’s sleep.
For side sleepers, the best mattress is one that conforms to body contours. The top candidate is memory foam mattresses no firmer than medium firm or medium. Other candidates are pocket coils (for those who still prefer innersprings) and latex mattresses. Again, the ideal choice is to have a memory foam top layer or a memory foam topper.
A firmer mattress is preferred for back sleepers, but not too firm. Memory foam eases pressure on the hips, shoulders, and heels with its conformity.
Pillow choices also figure into the equation. What pillows you use will depend on your mattress. If you are a side sleeper stuck with a very firm mattress, the pillows will be critical to your sleep quality.
To avoid shoulder compression for a side sleeper, a pillow under the chest slightly lower than the lumbar pillow may reduce pressure on the shoulder. A tapered pillow, thicker under the lumbar, would be easier to use than two pillows. It should be shorter than from the pelvic bone to the armpit.
Of course, the sleeper should have a head pillow that, when bearing the weight of the head, will hold the neck in line with the back. A shredded memory foam pillow (such as the Ultra-Luxury by Snuggle-Pedic) can be reshaped to fit the sleeper’s needs. And a pillow between the knees reduces hip rotation and pressure.
A good body pillow, such as that by Snuggle-Pedic, could be a good one-pillow option. Pregnant women may use a maternity pillow.
★ Adjustable Air Beds
The advantage of an adjustable air bed is in setting the firmness for your needs. However, if the air pressure (firmness) is too low for a sleeper, hammocking will offset the benefit. As the heavier midsection of the body presses down on the center of the air chamber, it pushes up the ends. For the side sleeper, this means more resistance under the shoulder.
Here is where tri-zoned air beds, such as Air-Pedic mattresses, have the advantage. This middle section is for the lumbar, and it can be firmer than the torso/head and leg/foot chambers. This means a side sleeper can have the air under the shoulder with enough give to relieve pressure.
Many air beds now have memory foam comfort layers atop the air support. Customer comments show that memory foam on air beds works better with tri-zoned air support than with single chambers.
★ Adjustable Bases
Adjustable bases are used to elevate one or both ends of a bed. The simplest and least expensive is an up base, which raises only the head and upper body. This can relieve snoring or sleep apnea for some back sleepers, as well as reducing gastric acid reflux. Raising only the head also makes this kind of base compatible with side sleepers. With a split-top adjustable base, the head sections can be elevated independently for two sleepers.
For users who cannot sleep on their sides, the fully adjustable base for your mattress – is ideal. It elevates the head and the feet. Raising the feet lowers circulatory stress by making it easier to return blood from the legs to the heart.
From the medical research studies as well as anecdotal evidence, sleeping on the left side appears to be the best option for most people, especially for those with obstructive sleep apnea and/or gastric acid reflux. There are ways to mitigate the disadvantages. And for those who cannot sleep on their sides for one reason or another, there are ways to compensate.
Appendix: Articles Related to Side Sleeping
- Marji, Brandon, A Chiropractor Warns: Don’t Sleep On Your Right Side, Providr (January 9, 2018), https://www.providr.com/sleep-on-your-right-side/ (accessed Feb. 15, 2018).
- WebMD, What’s the Best Position to Sleep In? (n/d), https://www.webmd.com/sleep-disorders/best-sleep-positions#3
- Parker-Pope, Tara, The Benefits of Left-Side Sleeping, New York Times, Well Blogs (October 25, 2010 1:58 pm), https://well.blogs.nytimes.com/2010/10/25/the-benefits-of-left-side-sleeping/ (accessed Feb. 15, 2018).
- O’Connor, Anahad, The Claim: Lying on Your Left Side Eases Heartburn, New York Times, (October 25, 2010), http://www.nytimes.com/2010/10/26/health/26really.html?ref=health (accessed Feb. 15, 2018).
- Sleep Apnea (Philips Respironics), Side, Back or Stomach: Which Sleeping Position is Best?, https://www.sleepapnea.com/blog/post/70507101890/side-back-or-stomach-which-sleeping-position-is (accessed Feb. 15, 2018).
MedCline, The Secret of Sleeping Reflux Free, by MedCline staff (26th Jul 2016), https://www.medcline.com/blog/the-secret-of-sleeping-refluxfree/; (accessed Feb. 15, 2018); cited sources:
- Lagergren, J, Bergstrom R, Lindgren A, et al. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med 1999; 340: 825-831.
- Fass, Ronnie. PPI bashing’ drives use of alternatives. gastoendnews.com, Sept. 2011.
- Khoury, Ramez M. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with Gastroesophageal Reflux Disease. The American Journal of Gastroenterology. Vol. 94, No. 8, 1999.
- Shay SS, Conwell DL, Mehindru V, et al. The effect of posture on gastroesphageal reflux event frequency and composition during fasting. Am J Gastroenterology. 1996; 91: 54-60.
- Stanciu C, Bennett JR: Effect of posture on gastro esophageal reflux, Digestion 1977, 15: 104-109.
- Person, E, Freeman, J, Rife, C, Clark, A, Castell, DO. A Novel Sleep Assist Device Prevents Gastroesophageal Reflux: A Randomized Controlled Trial. Journal of Clinical Gastroenterology. 2015 Sep; 49 (8): 655-9.
- Allampati SK, Lopez R, Ray M, Birgisson S, Gabbard SL. Use of a Sleep Positioning Device Significantly Improves Nocturnal Gastroesophageal Reflux Symptoms. Am J Gastroenterol 2014; 109:S1–S39.
- Pure Posture, Best Sleeping Positions (Aug 27, 2017), https://www.pureposture.net/blogs/hello/sleeping-on-your-stomach (accessed Feb. 15, 2018).
Appendix: Research Reports Related to Side Sleeping
(Sourced on PubMed, US National Library of Medicine, National Institutes of Health)
- Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO, Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease [Abstract], The American Journal of Gastroenterology, 1999 Aug; 94(8):2069-73 (PMID: 10445529; DOI: 10.1111/j.1572-0241.1999.01279.x), https://www.ncbi.nlm.nih.gov/pubmed/10445529?dopt=Abstract (accessed Feb. 15, 2018).
- van Herwaarden MA, Katzka DA, Smout AJ, Samsom M, Gideon M, Castell DO, Effect of different recumbent positions on postprandial gastroesophageal reflux in normal subjects, The American Journal of Gastroenterology, 2000 Oct;95(10):2731-6 (PMID: 11051341; DOI: 10.1111/j.1572-0241.2000.03180.x), https://www.ncbi.nlm.nih.gov/pubmed/11051341?dopt=Abstract (accessed Feb. 15, 2018).
- Bettlach, Carrie Roth, MSN, RN, FNP-C, Jenny Yu, BA, Jessica Hasak, MPH, RN, Greta Bodway, BSN, RN, and Susan Mackinnon, MD, Abstract: Side Sleeping Position is Associated with Less Frequent Nighttime Numbness and Tingling, Plastic Reconstructive Surgery Global Open, 2016 Sep; 4(9 Suppl): 123-124, Published online 2016 Sep 16. (DOI: 10.1097/01.GOX.0000503043.97116.f6; PMCID: PMC5147211), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147211/, (accessed Feb. 15, 2018); cited sources:
(1) Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Med J 2008; 77(1): 6–17.
(2) McCabe SJ, Gupta A, Tate DE, Myers J. Preferred sleep position on the side is associated with carpal tunnel syndrome. Hand (N Y) 2011; 6(2): 132–7.
(3) Atroshi I, Gummesson C, Johnsson R, Sprinchorn A. Symptoms, disability, and quality of life in patients with carpal tunnel syndrome. Journal of Hand Surgery; 24(2): 398–404.
- Zenian, J, Sleep position and shoulder pain, Medical Hypotheses, 2010 Apr;74(4):639-43. (DOI: 10.1016/j.mehy.2009.11.013. Epub 2009 Dec 24) https://www.ncbi.nlm.nih.gov/pubmed/20036076 (accessed Feb. 15, 2018).
- Warland, Jane,* and Jillian Dorrian; Karen L. Gamble, Editor, Accuracy of Self-Reported Sleep Position in Late Pregnancy, PLoS One, 2014; 9(12): e115760, Published online 2014 Dec 23. (DOI: 10.1371/journal.pone.0115760; PMCID: PMC4275245), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275245/ (accessed Feb. 15, 2018).
- Beattie, Zachary T., Student Member, IEEE, corresponding author Chad C. Hagen, and Tamara L. Hayes, Member, IEEE, Classification of Lying Position Using Load Cells under the Bed, Conf Proc IEEE Eng Med Biol Soc. Author manuscript; available in PMC 2012 Jun 4, Published in final edited form as: Conf Proc IEEE Eng Med Biol Soc. 2011; 2011: 474–477 (DOI: 10.1109/IEMBS.2011.6090068; PMCID: PMC3366489; NIHMSID: NIHMS379260), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366489/ (accessed Feb. 15, 2018).
- Cartwright, RD, Effect of sleep position on sleep apnea severity, Sleep (Association of Professional Sleep Societies), 1984;7(2):110-4 (PMID: 6740055), https://www.ncbi.nlm.nih.gov/pubmed/6740055 (accessed Feb. 15, 2018).
- George, CF, Millar, TW, Kryger, MH, during sleep, Sleep (Association of Professional Sleep Societies), 1988 Feb;11(1):90-9 (PMID: 3363274), https://www.ncbi.nlm.nih.gov/pubmed/3363274 (Accesses Feb. 16, 2018).
- Person, E, Rife C, Freeman J, Clark A, Castell DO, A Novel Sleep Positioning Device Reduces Gastroesophageal Reflux: A Randomized Controlled Trial, The Journal of Clinical Gastroenterology, 2015 Sep;49(8):655-9 (DOI: 10.1097/MCG.0000000000000359), https://www.ncbi.nlm.nih.gov/pubmed/26053170 (accessed Feb. 15, 2018).