Sleep Posture – What is the best sleeping position?

This article answers all your questions about sleep posture and sleep position. What even is sleep posture, why is it important, what sleep position is best, pregnancy sleep posture, the common sleep posture mistakes made and can sleep posture cause pain? All of this information and more is detailed below.

If reading isn’t quite your style check out this video by Osteopath Dr Abbey Davidson:

What is the best sleeping posture?

Back sleeping is the recommended sleep position The best sleep posture or position to sleep in is laying on your back.  It is recommended that in this position a slim pillow is placed under the head (to support the neck) and another pillow is placed under knees to maintain lumbar or low back curve. In this position all of your spinal curves are in a fairly neutral position. It is also important that your arms are by your side, and not above shoulder height. Sleep apnea can be aggravated by a back sleeping position; please consult your doctor if this is a concern for you.


Sleep position should encourage neutral spinal curves (lordosis and kyphosis)Side sleeping is the second best sleep posture; if it is done correctly! It is really easy to get side sleeping wrong. The transition from side sleeping to front sleeping only requires the top leg to be thrown over adding significant rotation to the spine and end range rotation to the neck. To avoid this, we suggest placing a rolled towel or pillow between the knees. Pillow height is very important for side sleeping; too high or too low removes the neutral curve from the cervical spine. It is important a pillow is firm in this situation to provide some structural support. The height will vary depending on the width of each person’s shoulders. Avoid hiking the knees towards the chest or the fetal position. Flexing of legs in the side sleeping positions reduces that natural curve in the low back. Side sleepers also have to avoid their arms raising above shoulder height.

Our take home message is to maintain a neutral spine. This means we want to preserve the natural curves of the spine during our recommended 7-9 hours of sleep.  The cervical spine (neck) and lumbar spine (low back) share a lordotic curve and through the thoracic (mid back) there is an opposite kyphotic curve. Twisting, bending, incorrect pillows, incorrect mattresses and obstacles (pets and children) can alter these natural curves and disrupt your sleep quality and cause you recurrent aches and pains.

For demonstration of proper sleep posture and some other helpful information watch our video with Osteopath Dr Abbey Davidson at the top of page.

What is sleep posture?

Simply, sleep posture is the position your body is in whilst sleeping. Just like your posture throughout the day we want to maintain good posture throughout the night.

Why is sleep posture important?

Pillow height is another important factor in getting side sleeping correctSleep is where your body is resting and repairing. We want to try and facilitate this and encourage rest and repair of the body. Good sleeping posture results in better sleep quality and better sleep quality results in improvements in mental and physical health, memory, learning ability, attention and energy.

Lack of good quality sleep or ongoing deficiency of sleep is linked to increased risk of heart disease, kidney disease, Alzheimer’s disease, high blood pressure, obesity, diabetes, and stroke.

Pregnancy and sleeping posture:

78% of women experience disturbed sleep during pregnancy. This is a bad combination when considering the energy demands of growing a small human. The following tips are to help improve sleep position and potentially sleep quality while pregnant.

Sleeping on your left side is recommended for pregnant women. This position encourages ease of breathing, circulation, decreases pressure on the liver and pumps more nutrients in to the placenta. While left side sleeping with knees slightly bent is considered the best during pregnancy, right side sleeping is not necessarily bad. Placing a pillow between the knees or using a body pillow may help you maintain this position for longer periods of time.

Propping a pillow under the belly after 20 weeks in this position can help reduce the strain on the low back by supporting the weight of the baby at the front.

Back sleeping is not advised during pregnancy – the weight of the baby rests on top of your intestines and major blood vessels/veins and can cause discomfort to the mother. If you wake up on your back it is not cause for panic just readjust back to your side sleeping position. Recent evidence shows there is a potential link between back sleeping and an increased incidence of still birth.

What are the common mistakes people make?

Front sleeping adds rotation through the lumbar and thoracic spine and adds extreme end range rotation through the cervical spine or neckSleep posture can be a hard thing to perfect but this are a few common mistakes to try and avoid:

  • Front sleeping. Avoid a front sleeping position at all costs. This posture adds extreme end range rotation to the neck and a twisting through the low and mid back. This position compromises breathing and circulation.
  • Too soft pillows. Do not use down or feather pillows as they don’t have enough structure or support for the natural curve of the neck
  • Too soft mattresses. Mattresses that are too soft do not maintain the natural curves of the spine.
  • Pillow height. Pillows that are too slim or too thick for the specific position and the specific size of each person is an important factor to get right. The cervical spine should be supported in neutral and not forced or exaggerated by incorrect pillow height. This can lead to muscular tightness and neck strain.
  • Avoid using multiple pillows. Purchase a pillow that is the correct height for your body and sleeping position. Ask your osteopath or physiotherapist if you are not sure about which pillow is correct for you.

Making the right decision about a pillow can be super confusing! Check out this video with Dr David Aboud (Osteopath & Physiotherapist) for more information:

Can your Sleep Position cause pain?

Some signs and symptoms which may suggest your sleep posture is not ideal may include:

  • Waking with neck pain
  • Waking with low back pain
  • Waking with Headaches
  • Low energy
  • Trouble concentrating

The longer that these symptoms are present increases the likelihood of needing physiotherapy or osteopathy treatment/intervention and increase the time until they fully resolve.


By Sydney CBD Osteopath Dr Abbey Davidson

#osteopath #abbeydavidson #quayhealth #sleepposture #sleepposition #sleep #posture #osteopathy #osteopathsydneycbd #osteopathsydneycity #osteopathcircularquay #osteopathwynyard #osteopathnearme #chiropractor #physiotherapist #remedialmassage