The Art of Sleep: Exploring the Relative Benefits of Different Sleep Positions
Sleep is an essential aspect of all our lives that affects our overall well-being, but it's especially important for people living with cancer. In my book, I have an entire chapter about the importance of sleep for cancer prevention, plus ways to improve sleep.
The optimum amount of sleep varies from person to person, but the importance of quality sleep remains consistent. One factor that can affect the quality of our sleep is our preferred sleeping position. Here, we're going to look at the relative benefits of sleeping on your back, stomach, right side and left side. Then you can decide which one suits you best.
Sleeping on Your Back
Sleeping on your back, also known as the supine position, has several advantages. It helps to keep your spine properly aligned, which relieves or prevents back and neck pain. On your back, your weight is spread evenly across the body, reducing pressure points, so you're less likely to get sore. Because there's less contact between your face and the pillow, it minimises wrinkles and reduces the likelihood of skin breakouts.
Lying on your back can sometimes increase acid reflux (1). If this happens, you can either prop yourself up with more pillows or raise the head of your bed. Acid reflux can become gastroesophageal reflux disease (GORD), which can be a trigger for carcinogenesis in the oesophagus (2).
Sleeping on your back may not be suitable for you if you suffer from sleep apnoea, as it can make it worse. Sleep apnoea raises your risk of all cancers (3). For example, obstructive sleep apnoea increases the risk of lung cancer by 30% (4) and doubles the risk of breast cancer (5).
Some people may snore more often sleeping on their back. If you experience these issues, one solution I've found helpful is to use mouth tape to seal your mouth and encourage you to breathe through your nose. Don't worry, you can open your mouth if you can't get your breath.
Some people may find sleeping on their back uncomfortable. If you sleep on your back, a pillow height of 10-12 cm (4-5 ins) won't push your head too far forward and strain your neck. Putting a pillow under your knees can take the strain off your back. If that doesn't help, it would be worth trying other sleep positions.
Sleeping on Your Stomach
Although you might find sleeping on your stomach (aka the prone position) comfortable, it has more disadvantages than advantages. On the plus side, it reduces snoring and symptoms of sleep apnoea in some people.
If you have back pain, you might find temporary relief by placing a pillow under your hips to maintain a more neutral spine position.
On the downside, stomach sleeping can strain the neck and spine, potentially leading to discomfort or pain. This position can also contribute to facial wrinkles. It might also limit your ability to breathe deeply during sleep. If stomach sleeping is your preference, consider using a thin pillow or no pillow at all to minimise strain on your neck and keep your spine better aligned.
Sleeping on Your Right Side
Right-sided sleeping can reduce the likelihood of snoring and help open up the airways.
If you have heart failure, sleeping on your right compresses the heart less than on the left, so it increases the heart's ability to pump blood (6).
Sleeping on your right side can increase your risk of acid reflux, though (1). The researchers aren't sure why, but one theory is that the sphincter between the oesophagus and the stomach relaxes more often when you lie on the right (1). Another possibility is that the sphincter is below the level of gastric acid in the stomach (1).
Sleeping on Your Left Side
There are some definite advantages to sleeping on your left side, especially if you have specific health conditions. Because the oesophagus is higher than the stomach, it stops acid from being regurgitated, so it can help if you have acid reflux symptoms.
Your brain has its own cleaning system for getting rid of waste, called the glymphatic system. Researchers have found that sleeping on the left side improves clearance of the waste. This includes beta-amyloid, which is implicated in the development of Alzheimer's (6). So, sleeping on your left may help reduce your risk of dementia in later life.
Your stomach empties on the left side of your body. And your colon moves the food you've eaten from right to left, so sleeping on your left side takes advantage of gravity to make it easier to digest your food (7).
It reduces the likelihood of snoring, because it keeps the airways open.
If you're pregnant, doctors recommend sleeping on your left, because it improves blood circulation to the foetus, kidneys, and uterus (8). It can also relieve pressure on your back and provide better oxygenation for both you and your baby.
If you choose to sleep on your side, either left or right, I'd suggest investing in a contoured pillow that allows you to adjust the height of the pillow. Ideally, you want to keep your head and neck aligned with both shoulders, which will help to avoid neck pain in the morning.
It's also worth putting a small pillow between your knees. This keeps your hips properly aligned, stops your knee joints from getting sore, and prevents strain on your lower back.
Conclusion
Finding the best sleep position depends on various factors. These include your own personal comfort and any underlying health conditions. Each sleep position has its relative benefits. Sleeping on your back and either side are preferable to stomach sleeping, as I mentioned above.
Experiment with different positions and see whether your sleep quality improves. You might find supportive pillows can help ensure a restful night's sleep and perhaps help to keep you in your chosen position.
Sleeping position is not the only factor for a good night's sleep, of course. You can discover many more tips to help you in my book. Find all the online stores that stock it by clicking on the Buy the Book button below.
References
Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? Archives of Internal Medicine. 2006;166(9):965-971. doi:10.1001/archinte.166.9.965.
Cancer Research UK. Risks and causes. Oesophageal cancer | Cancer Research UK. November 29, 2019. Accessed May 19, 2023. https://www.cancerresearchuk.org/about-cancer/oesophageal-cancer/causes-risks#.
Tan BKJ, Teo YH, Tan NKW, et al. Association of obstructive sleep apnea and nocturnal hypoxemia with all-cancer incidence and mortality: A systematic review and meta-analysis. Journal of Clinical Sleep Medicine. 2022;18(5):1427-1440. doi:10.5664/jcsm.9772
Cheong AJY, Tan BKJ, Teo YH, et al. Obstructive sleep apnea and Lung Cancer: A systematic review and meta-analysis. Annals of the American Thoracic Society. 2022;19(3):469-475. doi:10.1513/annalsats.202108-960oc
Yap DWT, Tan NKW, Tan BKJ, et al. The association of obstructive sleep apnea with breast cancer incidence and mortality: A systematic review and meta-analysis. Journal of Breast Cancer. 2022;25(3):149-163. doi:10.4048/jbc.2022.25.e11
Lee H, Xie L, Yu M, et al. The effect of body posture on Brain Glymphatic Transport. Journal of Neuroscience. 2015;35(31):11034-11044. doi:10.1523/jneurosci.1625-15.2015
Chesak J. How These 3 Sleep Positions Affect Your Gut Health. Healthline. March 20, 2023. Accessed May 22, 2023. https://www.healthline.com/health/healthy-sleep/sleep-effects-digestion#side-sleeping.
Marcin A, Robinson D. What are the best sleeping positions when you're pregnant? Healthline. April 13, 2023. Accessed May 22, 2023. https://www.healthline.com/health/pregnancy/sleeping-positions-in-pregnancy#side-sleeping.
