What sleeping position is best? A sleep specialist explains.

How improving sleep can mean better cardiac health

Everyone wants a good night of sleep, but your go-to sleeping position can affect how restful your night is — and how your body feels the next day.

So which position is best: side, back or stomach sleeping?

Ellen Wermter, Better Sleep Council representative, family nurse practitioner and behavioral sleep medicine specialist, told CBS News it's more about what works for you, not which is considered the "best" position overall — though each has some pros and cons.

"As far as advantages and disadvantages, it all of it depends on how you feel the most comfortable and pain free," she said. "In general, we're trying to maximize a couple of things: spine alignment and breathing."

Here's what to know about each position: 

Back sleeping

Certain sleep conditions like sleep apnea are "very positional," Wermter said, which can make some positions — like back sleeping — worse than others.

"When you're on your back, you have a lot of gravity working against you," she said. "Your tongue tends to fall back, things tend to relax and you get more obstructions of the airway."

So if you are prone to airway obstruction, it's might not be the best option.

Back sleeping can also cause snoring, according to the National Sleep Foundation, since it can narrow your airways due to gravity.

The positive of back sleeping? It's excellent for spine alignment. 

"It keeps everything in such a nice, neutral position. And your weight is very evenly distributed when you're on your back — those are really big pros," she said.

Side sleeping

Side sleeping, on the other hand, is "pretty good for breathing," Wermter said. 

"The left side in particular is considered excellent for cardiovascular (circulation), the return of the blood flow — that's why (it's often) recommended for pregnancy as well," she added.

Sleeping on your right side can also make heartburn and GERD — gastroesophageal reflux disease— symptoms worse, according to Johns Hopkins Medicine

Side sleeping can also be OK for spine alignment, Wermter said, particularly when using pillows to keep things as neutral as possible.

"When you're on your side, it's really about filling in that little gap your neck makes," she said. "The other piece is lining up the hips — putting a pillow between the legs is often comfortable or supporting a shoulder or an arm to keep that neutral alignment with the spine."

Stomach sleeping

"Stomach sleeping is considered the most problematic because it is hard to get that neutral spine (and neck) position," Wermter said. "Your face is sort of pressed into the mattress or the pillow, so you have to turn your neck to one side or the other."

Superficially, you can also get more wrinkles from stomach sleeping because of the pressure of your face into your bed.

"So if that's something you're worried about, then that's a negative for stomach sleeping," she said.

If you're not washing your pillowcases regularly enough, stomach sleeping can also lead to breakouts, according to Johns Hopkins. 

If you do stomach sleep, Wermter suggests choosing a flatter pillow (or none at all) in order to reduce your neck from being arched back more.

What sleep position should I use?

Listening to your body is key to finding what sleep position is best for you.

"If you're gasping awake and you're on your back, well that's probably not the best position for you for breathing, or if you're on your stomach and you're feeling the pain in your neck, that's probably not working for you," Wermter said.

Position preferences can also change as you age or as you deal with things like surgeries, so be open to adjusting as needed. 

 "You do have to adapt to what's going on in your life or what recovery you're currently dealing with," Wermter said, adding she's personally switched from her previously preferred stomach sleeping to side sleeping as she's gotten older. "It does change over time based on how flexible you are, how stiff you get."

While it can be really difficult to train yourself into a different sleeping position, it can be done.

"Because our brains get so used to their comfort position, it can take some time and some persistence," she said. 

Wermter also suggests using pillows to your advantage. In addition to testing out what height and size works best for your position of choice, you can also use them to prop or stabilize yourself in a particular position. 

Still struggling with sleep?

If no position is leaving you rested, consider what you're sleeping on. 

"All of these positions are going to be best on a good sleeping surface. So if you're starting with a mattress that doesn't have good support anymore or is sagging, then even your best efforts aren't going to be optimized," Wermter said.

Consistent tossing and turning despite your best efforts could also mean you're dealing with a sleep disorder, which can affect your energy level, mood, productivity and cognitive function, according to the National Sleep Foundation. 

"It can also lead to more critical problems down the road, including conditions like high blood pressure, cardiovascular disease, diabetes, and stroke," the foundation's website states. "If you're regularly having trouble sleeping or experiencing daytime fatigue even though you thought you slept soundly through the night, it might be time to talk to a doctor about your concerns."

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