Is Stomach Sleeping Bad for My Neck?

by | Jul 19, 2018

(Is Stomach Sleeping Bad for My Neck?  Part 1 of our Sleep Posture Education Series)

The Importance of Posture

Our physical therapists and occupational therapists frequently provide recommendations to patients on adjustments to sitting and standing postures that are necessary to reduce postural strain and pain. We also advise on modifications to sleep positions, especially stomach sleeping, which are necessary to eliminate back pain and neck pain.   During the course of our initial interview with a client, we inquire into their sleep habits to determine if those habits are contributing to their current pain syndrome.  Several topics that are raised in our discussion of sleep habits include:

1. Are you a stomach sleeper?
2. Do you have GERD?
3. Are you a back sleeper? Are you a side sleeper?
4. What type of bedding and pillows do you use?  How old are they?
5. Do you watch TV in bed?

Is Stomach Sleeping Bad for Me?

Many people find sleeping on their belly (prone) to be helpful in reducing snoring and sleep apnea.  While this may be very desirable (especially for sleep deprived spouses), sleeping on your stomach can be a very stressful position for the neck.  In a prone position, the cervical spine is placed into what therapists refer to as a closed pack position.  Closed pack positioning for the cervical spine is extension, or bending backward.  In addition, when you sleep in a prone position, the neck is fully rotated which places some ligaments, discs, and muscles into a fully stretched or taut position.  Biomechanically speaking, when you sleep on your stomach, your neck is in a fully rotated and extended position and often remains there for several hours.

Try it yourself right now:

First, in a seated position, turned your head fully left or right and keep it there.

Second, tilt your head backward.

Comfortable? Could you stay in this position for seconds? minutes? hours?  While sitting also adds the variable of compression to the neck (which is not present when laying prone), this tightness is essentially the same.

Tips for Stomach Sleepers

The main goal of sleep positioning is to place the spine into a neutral spine position that eliminates any bending and rotation.  This is hard to accomplish when in the stomach sleeping position.

Use a firm, body pillow placed under the half of your body that is also on the same side as your head turn, i.e. head turn left, body pillow placed under left side. By doing this, you reduce the amount of rotation and extension of the neck, thus reducing the tension placed on the discs, ligaments, and musculature.

Always use a thin neck pillow, or don’t use a pillow at all. The flatter the pillow, the less angled your neck and the head will be.

Choose a mattress designed for front sleepers. Typically, that means a slightly firmer than average bed. It will allow you to get a good night’s rest on your stomach. A softer mattress will typically place your neck into an extended position.

Putting a pillow under your pelvis is guaranteed to help. It will keep your back in a more neutral position, taking the pressure off your spine. If your body is somewhat portly around the mid-section, a pillow may not be needed since you essentially have one built into your body.

Two to three minutes of stretching in the morning will help you to put your body back into alignment and strengthen the supporting muscles. Always start the stretching session with a little bit of warm up, and be gentle!  Remember: as we age, it is not uncommon nor abnormal to feel stiffness upon waking due to arthritic changes that may be present.  A morning stretch, a hot shower, and a few minutes of walking will often eliminate this stiffness.

Special cautions for moms-to-be

When you’re “sleeping for two,” you need as much quality rest as you can get.  The very notion of stomach sleeping is laughable late into your pregnancy, but you’ll want to avoid it early on, too. That extra weight around the middle will increase the pull on your spine.

Also, your baby will have more room if he or she isn’t forced to squeeze in between your spine and the mattress. A 2012 medical study suggests that sleeping on your left side when you’re pregnant can increase healthy blood flow and provide the optimum oxygen levels for you and your baby.

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