Best Position to Sleep? Suggestions for Back Pain, Neck Pain and Headache Sufferers

He seems to be sleeping comfortably, but you can actually find two errors in his sleeping position. Can you tell what they are?

I had a first-degree encounter with a bad sleep position a couple of weeks ago. It was a miserable start for a day: I was woken by an overeager telephone salesman and with a mild crick in my neck.

I can’t actually remember what position I woke up in – must’ve been that bloody salesman’s fault – but in all likelihood I was sleeping on my side, which shouldn’t be such a bad position to sleep.

The crick in my neck reminded me about what I learned about good sleeping positions a few years ago.

Below you find some suggestions for arranging pillows for your best sleep position, whether you sleep on your back, side or stomach. They should be good for anyone who suffers from headaches and neck and back pains. (I learned these pillow placement tricks from Lisa Morrone’s Overcoming Back and Neck Pain).

1. Sleeping on your back is the best position to sleep for most people.  However, if you use a wrong pillow or place your pillows incorrectly, sleeping on your back can cause problems (especially if you suffer from neck, shoulder and back pains).

If you sleep on your back, your pillow should be positioned under your head and neck, not under the shoulders. If you use several pillows, turn the top pillow lengthwise (parallel to the body) so it reaches under you mid-back, not just under your shoulders. That way your neck joints aren’t forced into an awkward angle even if you use several pillows.

For extra comfort, you may also like to place a pillow under your knees.

2. Sleeping on your side.  Sleeping on your side is the next best position to sleep. It comes with several qualifications though. 🙂 The basic rule is that there must be enough support under your head to keep your nose in line with your breastbone. If your pillow is too flat or too plump, it may be a good idea to change it. Your top arm should rest on your side.

To prevent your spine from rotating and side-bending, you should also place a pillow lengthwise between your legs. The lengthwise pillow also prevents you from pulling your legs in a fetal position, which is bad for your lower back.

Getting a bodypillow may be a good idea.

You think you’re done with pillows? Dream on. If you suffer from headaches and neck pain, you may need a third pillow that is placed lengthwise in front of your trunk. The function of your pillow is to prevent you from sleeping in the forward shoulders position you easily adopt when you work too much in front of the computer (It appears that that hunchback posture haunts us even in our sleep!).

Getting a body pillow may be a good idea. Your bed can get quite crowded if you sleep with three pillows. I often wake up in the middle of the night and notice that one of my pillows is MIA.

3. Sleeping on your stomach. In general, sleeping on your stomach is a big no-no, because it forces your cervical spine at an 90-degree angle and puts stress on your low back.

To sleep comfortably on your stomach, you need three regular pillows or one body pillow and one regular pillow under your head. The placement of the pillows is similar to the side-lying example above, except you place your head on the edge of your pillow so that your face points toward the mattress in a 45-degree angle (instead of 90-degree angle). The top arm rests in front of your trunk, supported by the body pillow.

You aren’t really sleeping on your stomach, but it’s as close as you can get without putting your spine into risk.


What is your best position to sleep? Do you need special arrangements?

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  1. Love this Satu – really interesting. I tend to vary between my stomach and my side (I think). Not sure what happens ONCE I go to sleep. I use a really low pillow and they’re hard to find. I’m traditionally fussy when it comes to my pillows as well.

    On both trips to hotels in recent months I’ve ended up using a folded bath towel at some point because the pillows have been too high.

    I love that you seek out this sort of information!


  2. Satu says:

    Hi Deb!

    I’m full of this kind of info! 🙂 I learned it when my tension headaches and neck pains were worse than they are today.

    Based on my recent experiences, I’m afraid I’m turning into a “picky” traveller already! When do I have to start taking my own pillows with me when I travel?

  3. Aimee says:

    I generally sleep on my back though I may shift to my side during the night. I sleep with 2 pillows. I sleep well most nights. Since the birth of my son I have experienced this strange back pain. It occurs only when I sleep at night, not when I sleep in the afternoon on nights I work. I wake up with back pain, stiffness in my back and it’s difficult to straighten up immediately. Within about 15 minutes it’s gone. It is the strangest thing. When it first started it was horrendous. For the last four years or so it has been tolerable. I never saw a doctor about it because there were no symptoms while awake.

    I find my son asleep on his stomach particularly when he just falls asleep. He is all over the place so he doesn’t usually stay that way. I could never understand sleeping on one’s stomach. It seems so uncomfortable.

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