One sleeps best in a fetal position on his side, while the other lies on his back, like a soldier with his arms at his sides. And for some sleepers it seems as if they have landed on their stomach in free fall. You often get all kinds of advice about which position is best, for example from sleep influencers on social media. Such as that the supine position is better for your spine – which is then straight – or that a side position stimulates blood circulation, so you wake up more rested. But is that also true?
“The fact is that such claims about sleeping positions are difficult to substantiate, because there is no such thing as a side sleeper, back sleeper or stomach sleeper,” says Lisette Venekamp, pulmonologist-somnologist and medical director of the Netherlands Sleep Institute: “How much you move in your sleep is different per person and per night, but everyone changes position several times during the night. You can therefore rarely point to a specific sleeping position as the cause of a bad night’s sleep.” Neurologist-somnologist Thom Timmerhuis of the Sleep Wake Center of the Jeroen Bosch Hospital agrees: “The regularity of sleep and the duration of sleep are especially important. Not whether you lie on your back, stomach or side. For healthy people, the body adapts itself: if you are not lying properly, you will turn.”
Reflux
It has therefore not been proven that a specific sleeping position causes health problems. But for people with certain health problems, posture can affect the quality of sleep. “For some people who snore or have apnea, breathing stops, this becomes worse when they lie on their back,” says Venekamp. “You may recognize it from a snoring partner. If snorers lie on their side, with or without a nudge, they are less bothered. A side position can also be more pleasant for people with reflux and acid reflux.”
Timmerhuis: “These ailments can keep you awake. If you are stimulated by an unpleasant sensation in your shallower sleep phase, it will be more difficult for you to continue sleeping.” Venekamp: “If you often sleep poorly and do not wake up rested despite sleeping enough hours, it is a good idea to have this investigated.”
Chronic pain complaints, such as neck pain, lower back pain and shoulder pain, can also significantly affect the quality of sleep, says professor of physiotherapy Raymond Ostelo of the Vrije Universiteit Amsterdam and the Amsterdam UMC. “It is important for these people to find out how they can lie more comfortably.”
The mattress plays an important role in sleeping comfort for people with back pain, says Ostelo. “It is often said that a firm mattress is beneficial for people with back pain, but a review study shows that medium-firm mattresses are most suitable. It must be said that there is no generally accepted method of measuring the hardness of mattresses. Ultimately, it comes down to the personal experience and comfort level of individuals.”
‘No one size fits all’
Special ergonomic pillows can also improve sleeping comfort for specific complaints. “But what works for one person may lead to more complaints for another. There is no one size fits all”, says Venekamp. People who suffer more from apnea when lying on their backs may benefit from positional therapy. They wear a device that produces a vibration when they turn on their back. “Stying an old-fashioned tennis ball behind your back can also work,” says Timmerhuis.
“But if you have no specific complaints, you should not be frightened by claims about things we do ‘wrong’ in our sleep. If you force yourself into a certain position, this can be counterproductive for your night’s sleep,” says Venekamp. Timmerhuis also sees this: “Good sleep is partly psychological. In our clinic we see many people with subjective sleep problems: they think they are not sleeping well, while measurements do not reveal this.” Venekamp: “They are sometimes told to do this by, for example, sleep influencers on social media.”
“Ultimately, your personal comfort is the most important thing: if you think you are lying comfortably, then continue to sleep well. And if not, test what suits you best,” Timmerhuis advises. “For example, you can test sleep on most pillows and mattresses for two weeks. Take advantage of this before purchasing expensive things.”
