Sleep positions, ranked

If you’re experiencing mysterious aches and you can’t pinpoint the cause, they might not be from poor posture or lifting form. Instead, your issue might be how you carry yourself in bed.

Even with the perfect setup, your sleep position can cause structural and internal problems that lower the quality of your nightly shuteye and your daily movements.

Once you’re conscious about how it affects the body, the payoffs are huge, says David Harris, vice president of human performance at Equinox in New York City. You’ll rest more soundly, work more efficiently, move more smoothly—the benefits go on.

To find out whether you gravitate to your stomach, sides, or back overnight, take note of how you’re positioned when you fall asleep and when you wake up. Then learn what it’s doing to your body (and how to minimize the damage, or avoid it altogether) using the guide below.


This is the worst position for the body because it takes you out of neutral alignment and puts pressure on all the organs, muscles, and nerves, Harris says. Some experts recommend lying down on your side and boxing yourself in with pillows, and even sewing a tennis ball to the front of your shirt, to discourage your unconscious self from flipping over in the night.

The problem: Since you can't sleep face down into your pillow, your neck will be rotated. “Spending six to seven hours with your head turned to one side night after night can leave a lasting impact on your neck,” says Matt Berenc, director of education at the Equinox Fitness Training Institute in Beverly Hills. Neck pain is a common side effect.

The fix: A licensed massage therapist can help you manage any tension that’s built up, he says. For self-guided work, he recommends the lateral flexion stretch (gently reaching your ear toward the shoulder on that side) and the rotation stretch (looking over your shoulder and reaching the chin toward the collarbone). Be gentle and practice belly breathing to relax the muscles, he adds. “No matter what you do, the key is to try to counter the position you’ve been in for hours,” he says, so note which way your head was turned that night and lightly stretch it in the opposite direction.

The problem: Stomach sleepers often have back problems because the position messes with the natural curves of the spine, Berenc says.

The fix: Finding the right mattress is key. If it’s too soft, the hips sink, making the curve of the lumbar spine more pronounced. In that case, the goal is to minimize sag in the middle of the body. Berenc also recommends doing planks, hip bridges, and other exercises to strengthen the core and ease lower-back pain.


While not necessarily bad, resting on your side creates imbalances in the body that you’ll want to correct. “The longer you stay in one position, the more important it is to get out of that position,” says Matt Delaney, national manager of innovation at Equinox in New York City.

The problem: Sleeping on your right exacerbates heartburn and acid reflux, potentially because it relaxes the lower esophageal sphincter, the muscle that connects stomach and esophagus.

The fix: Harris suggests finishing your last meal two to three hours before bed. Avoid acidic foods like tomatoes and citrus, as well as some meats like steak, which requires more stomach acids to break down, he adds. Instead, stick to alkaline foods like legumes, tofu, and most fresh produce. They lower the body’s pH, a measure of acidity.

The problem: The stomach and pancreas (which releases fluids into the small intestine that help break down foods) hang on the left of the body. Resting on your right takes them out of their natural positions, slowing digestion.

The fix: Eating your last meal two to three hours pre-sleep gives the body time to digest before you tuck in.

The problem: Sleeping on either side can compress and extend the bundle of nerves, arteries, and veins in the neck. This bundle branches off into the chest, rib cage, arms, and fingers. This can impact the nerves in the cervical spine and cause radiating issues like pins and needles, Delaney says.

The fix: Buy a pillow that keeps your spine in neutral, he says. Use one that’s too hard and it’ll prop your head up; too soft, and your head will droop. You want your profile to face the ceiling, not to be tilted back toward the headboard or up toward your feet. Do your best to sleep on your left as much as on your right to balance out the effects and see a licensed massage therapist or doctor of physical therapy if the pain persists.

The problem: Side positions (like fetal) put you in back flexion, or a hunched posture, for hours at a time. “If you sit at a desk for eight hours a day and you like to cycle, then you’re almost always in a flexed position,” Delaney explains. That limits your range of motion and makes it harder to breathe deeply, since repeated flexion compresses the diaphragm.

The fix: Get yourself into extension to counteract your postures at work and in bed, Delaney says. He recommends doing moves like cat-cow, clam shell, and backward-leaning moves with a ViPR to open up the thoracic spine. Practice deep belly breathing to expand the diaphragm, he adds.


This is the best position because it allows for even distribution of weight, it doesn’t put pressure on the muscles or organs, and it makes it easiest to stay in neutral alignment, Harris says. Still, there are a couple caveats.

The problem: Sleeping face up makes the base of your tongue and soft palate collapse to the back wall of the throat, potentially turning sound breathing into snoring. “When the collapse is so bad it causes a full block of the airway, it leads to sleep apnea,” says Berenc.

The fix: If your droning wakes you (or your partner) up, he suggests trying a slightly inclined position, with pillows that keep your neck in neutral. If you continue to snore or have a hard time breathing, see your doctor to rule out problems like sleep apnea.

The problem: It can also put pressure on the back. If the mattress is too soft, the hips sink, flattening the spine. If it’s too hard, the glutes don’t ease into it at all, exaggerating the curve of the lower back.

The fix: Put a bolster under your knees. “This will create a little bend and potentially take some pressure off the low back,” Berenc says. You should also find the mattress and pillow that help you keep a neutral position free of unnecessary twists and curves in the spine and neck.