By Jakob van Vlijmen
M Chiro, DC
As people spend almost one third of their life being asleep, it’s not strange that we get a lot of questions regarding sleep in our practice. More and more people realise that correct sleeping posture and the right mattress are vital for feeling refreshed in the morning. And what is more if done incorrectly; sleeping can be a tremendous strain on your neck and back! The following article will tell you what to look out for and should give you the tools to be able to make sure your sleep is as revitalising as possible.
The correct sleeping posture allows for the spine's natural curvature to be maintained. To help explain this we have to look at the spine's anatomy. As some of you may know, the spine is built up of 24 vertebras, a sacrum and a coccyx. The spinal column has a typical S shape with a concave cervical and lumbar curve and a convex thoracic and sacral curve.
During the day the spine is under a lot of stress especially when, during our activities, we are unable to maintain the natural curves of our spine. As discussed in previous articles, correct posture during sitting and lifting is very important to prevent excessive loading of our spines. (For more information on how to sit or lift correctly visit our YouTube channel: https://www.youtube.com/user/sportsandspines) More and more people are becoming aware of this, which is great, however they do not seem to realise the same principles apply at night. An incorrect posture can cause incorrect and excessive loading of our joints. The following pictures should help explain what certain sleeping postures do to your spine.
Sleeping on your stomach
Sleeping on your stomach is bad for your spine as the neck is stressed by having it fully rotated and the lower back's curvature is increased causing more load on the lower back. (Image 2)
Even without a pillow the amount of cervical rotation necessary for this position can cause or perpetuate neck pain or headaches. Trying to change your sleeping position can be difficult, but there are some tricks we can teach you to help facilitate your change over to a healthier sleeping position. Ask your chiropractor about this if you want to learn more.
Sleeping on your back
When you lie on your back the weight is distributed equally over a large area, this is why this position is deemed best for you. It is important however, that when you lie down on your back you are able to maintain the natural S shape of your spine. At times it is possible that the curvature in the lower back is not sufficiently supported, usually this is the case if the matrass is too hard. To prevent injury and maintain the natural curvature, you can put a pillow or towel underneath your lower back to support it. Another way of de-loading the lower back is sleeping with slightly bent knees by placing the pillow underneath your legs as shown in image 3.
When you sleep on your back you need a good pillow to support your head and neck. The height of the pillow is dependent on the curvature of your neck. The pillow needs to support the neck in such a way that the concavity is completely filled up otherwise this may cause a deviation from the necks natural curvature (see image 4). When you sleep on your back, a fairly flat pillow will suffice, however when you sleep on your sides you will need a slightly fatter pillow.
Image 4a: pillow is to high Image 4b: pillow is to low Image 4c: correct pillow height
A pillow that is too hard can cause issues as well as it can create too much pressure on the back of the head. A softer pillow can be more supportive of both neck and head and therefore more suitable, ask your chiropractor if the pillow you are currently using is right for you.
Sleeping on your side
Sleeping on your side is a very suitable position, provided you are sleeping on the right pillow and mattress. When lying on your side the neck can tilt sideways due to the width of the shoulders. This is why it is important to have a pillow that is the right size so the head and neck are properly supported. Use one pillow that has the correct height (see image 5) and try avoiding folding a thin pillow up or using 2 stacked pillows.
Image 5a: pillow is to low Image 5b: pillow is to high Image 5b: pillow is the correct thickness
There are different types of pillows and the ones gaining popularity right now are the orthopaedic ones. We also stock these at IOSAS as they are shaped to perfectly fill up the area underneath your neck and head when you sleep on your side. What is very important when you buy a pillow like this is that you buy the correct size as it is intended to fill up that space and support your neck and head in such a way that your spine is able to remain straight.
Buying the correct mattress is very important, sadly there is no such thing as the perfect mattress as each one has their pros and cons. And some of these considerations are purely personal. A mattress, depending on the quality, should last about 10 years. The weight of the body distributed differently across the mattress, as you are lying on your side there will be different forces acting upon the hips than on the neck or chest. If the mattress is too soft, too much pressure can be exerting on the spine and it can sink through, as a hammock does (see image 6a). This can lead to neck or back injuries. A mattress that is too hard firstly doesn't provide enough comfort but can also cause neck and back injuries (image 6b). The drawback from sleeping on your side is that the bodies’ contours play a big part; the pressure is higher in areas where the body is wider. In places where the body is narrower it needs more support from the mattress. There are mattresses that are able to give varying degrees of support to keep the spine straight.
Image 6a: Mattress too soft Image 6b: Mattress too hard Image 6c: Mattress has correct firmness
Lying on your side, on a good mattress with the arms besides the pillow and the legs tucked in slightly with a pillow in between the knees is the sleeping position that causes the least load on the spine and neck (see image 7)
If you are wondering if your pillow or mattress is right for you, ask your chiropractor about it during your next visit. If you can, bring in your pillow for them to have a look at and ask the team at IOSAS about the mattresses and pillows we sell.