On the other hand, for those who suffer from sleep apnea or even just simple snoring, sleeping on one’s back causes gravity to work against your airway, encouraging it to close more, explained Dr. Clete Kushida, medical director of the Stanford Sleep Medicine Center. Salas noted that 80 percent of people who meet the diagnostic criteria for sleep apnea are not diagnosed and that some people have positional sleep apnea, which mostly occurs when they end up on their backs. Back-sleeping may also not be particularly great for those who experience heartburn, Salas said.
Staying off of your back while unconscious can be tricky to manage, and people with sleep apnea may not realize that they are experiencing minor sleep disruptions as often as sixty times an hour that fragment their sleep without awakening them all the way. Some people try to avoid it by attaching a tennis ball to their back. Kushida warns against this—it will only disrupt your sleep even further. On the other hand, the experts mentioned other devices that might be worth trying out: vests with attachments on the back or devices that wrap around your chest, sense your body position, and lightly vibrate to inspire you to shift off of it—without waking you up.
“Some people really love sleeping on their stomach,” Salas said. “For those people, if you really wanted to up your game, maybe think about a pillow that will allow you to have a little more neck support.” This may not matter so much for young people, but it can be helpful as you get a little older. (A quick side note to my fellow less-and-less young sleepers: Collop said it is natural to wake up a little more often through the night as you age—which quieted some growing anxieties I’d had.)
For those concerned about skin care, stomach-sleeping isn’t great for preventing wrinkles on your neck and chest, Salas said. It can also maximize your face’s contact with your pillow case—which may have dust or built-up oils—and increase the risk of acne. (Back-sleeping might be a better option here.) If you really love sleeping on your stomach, you could consider investing in a good pillow and washing it often as part of your skincare investment.
Considering what you’re sleeping on also extends to your limbs. If you realize that you’ve been sleeping on your arm a lot (perhaps because it remains “asleep” after you wake up), that may be a cause for unhelpful disruptions, Salas explained. If you’re unsure whether this or something else is going on, she suggested that curious people could create their own one-person sleep clinic and film their full bodies sleeping three times over three weeks to see what their sleeping self is up to.
There are a lot of variables for us side sleepers. For instance, you have one back and one belly, but two sides. Because of how our bodies are organized internally, Salas said it might be better to sleep on your left side rather than your right. That’s can be especially true if you experience heartburn. (Those with reflux trouble could also consider sleeping at an incline, Salas said; Collop recommended putting six-inch blocks beneath your front bed posts instead of using a wedge pillow, since the latter can crunch your stomach a little. Kushida also said sleeping with your head elevated by at least 30 degrees can help those with sleep apnea.)
Though spine-alignment is not a universal need, if you have been experiencing some back or neck pain, Kushida recommended sleeping on your side and using your mattress and pillow to position your spine in a straight line from your head to your pelvis; the more parallel to the floor it is, the less tension your spinal column will have to endure. If you’re going mattress-shopping at a store, he said to spend as much time as you can on it to make sure it doesn’t cause any problems. Kushida and Salas both suggested placing a pillow between your knees to help even your body shape out and alleviate pressure on your back and hip joints. If you want to stay on your side through the night, put a full-body pillow beside your back. And if you’re sleeping next to someone as the big spoon, maybe look into a pillow with a cut-out for your arm, so that your partner isn’t the one sleeping on it; if you’re the little spoon and either of those arms are bothering you, say so and work with your partner to find something better.
None of these are strict prescriptions. It cannot be repeated enough: The point is to seek out new ways, both big and little, for comfort to win out over discomfort. But if you have tried all of this and are still waking up multiple times a night, struggling to fall back asleep, and waking up the next morning feeling poorly rested, then it might be time to stop self-experimenting and seek out some professional help. “Everyone has different sleep needs,” Collop said. It’s just a matter of figuring out exactly what yours are.