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Tell me how you sleep, and I'll tell you how good (or bad) you’re doing

Dime cómo duermes y te diré cómo te va

If we spend about a third of our life sleeping, we should be resting with the purpose to restore our mind and body. Although we know at least a dozen tips to help us fall asleep and stay asleep the entire night, there are certain details about sleep, such as posture, pillows, or even where to put your arms, that make a big difference. Let's review what the experts say about getting the most from your sleep.

Different Postures

Everyone sleeps in the position that suits them, when the idea is to provide correct alignment to the spine, especially the cervical or upper spine. There are seven vertebrae. The smallest, at the back of the neck, is where tension, fatigue, and stress of routine and daily life accumulates!

If you have a lot of tension in the muscles in that area, take magnesium to help relax them.

But which posture is the most appropriate? Not all experts can agree. While some chiropractors prefer laying on the back, neurologists prefer on the side, specifically the left side. The reasons:

  • The face up posture may be the most appropriate for those with a soft mattress, since that position provides support to the lumbar area (behind the hips and over the buttocks). If you experience discomfort in that area, though, this posture is not recommended because it contracts the muscles that flex the hips. A simple and economical way to prevent that discomfort is to place a pillow under the knees and calves to lift them. This will provide the hip muscles a rest.

  • The side posture, especially with knees bent, allows the body to rest because it helps the lumbar curvature. There have been recent discussions claiming the best side position is on the left side due to multiple benefits. According to research, it improves lymphatic drainage of the brain, discarding toxins, and reduces obstructive apnea while improving blood circulation, among other things (1). However, this position can aggravate people who suffer from gastroesophageal reflux (2).

  • The face down posture is the least recommended, especially for those with a high pillow. This position does not support the head and completely misaligns the spine, almost as if there had been a neck injury. In addition, sleeping face down further sinks the waist (known as lumbar hyperlordosis), especially when the mattress is soft. If you are accustomed to this posture, sleep without a pillow or use a very thin one. Opt for a firmer mattress if possible. If you can’t, place a thin pillow or folded blanket under your pelvis for support. You can also try a semi-recumbent position by bending one leg forward. This can help distribute weight and avoid excess tension, especially on the shoulder that is bearing the most weight. (3)

Pillows – not too firm, not too soft

Although studies on the actual effects of pillows on sleep are not conclusive (4), most spine experts agree that a pillow should be the right height to support the alignment of the spine and cervical curve. This can undoubtedly help improve sleep and overall quality of waking life. (5)

Some small studies have shown that orthopedic pillows can, in most cases, improve rest due to their shape and material (5). Those with rounded ends and a more pronounced curve for neck support may be beneficial. This is because, when used correctly, they provide the appropriate height to help maintain cervical alignment.

Keep arms inside at all times

Most side sleepers tend to put their arms over their head. According to one study, this puts unnecessary pressure on the elbow while the person sleeps, which can worsen an injury if one is present.

If the arm is flattened and extended out to the side, hanging down, it can cause pressure on the nerves. Spending too much time in this position can cause numbness, momentary paralysis, and tingling (6). This is very common, however, and should only be cause for concern if repeated frequently. The suggestion is to sleep with the arms downward on either side. (7)

Our sleeping posture cannot be 100% effectively controlled. It depends largely on our habits, even the amount of exercise we do, how well we manage stress, and the healthiness of our routines. Being more conscious of settling into bed, coupled with a warm passionflower tea[d] and proper sleep hygiene, can add up to a good night’s rest for all of us.

Let's be healthier together.

Your Santo Remedio Team


1. Hedok Lee, Lulu Xie,* Mei Yu,Hongyi Kang,5 Tian FengRashid DeaneJean Logan, Maiken NedergaardHelene Benveniste. The Effect of Body Posture on Brain Glymphatic Transport. J Neurosci. 2015 Aug 5; 35(31): 11034–11044. doi: 10.1523/JNEUROSCI.1625-15.2015. PMCID: PMC4524974
2. P Malfertheiner B Hallerbäck. Clinical manifestations and complications of gastroesophageal reflux disease (GERD) Int J Clin Pract. 2005 Mar;59(3):346-55. 
doi: 10.1111/j.1742-1241.2005.00370.x. PMID: 15857335 DOI: 10.1111/j.1742-1241.2005.00370.x 
3. John Zedian. Sleep position and shoulder pain. Med Hypotheses. 2010 Apr;74(4):639-43. doi: 10.1016/j.mehy.2009.11.013. Epub 2009 Dec 24. 
4. Susan J Gordon, Karen A Grimmer, Petra Buttner. Pillow preferences of people with neck pain and known spinal degeneration: a pilot randomized controlled trial.Randomized Controlled Trial. Eur J Phys Rehabil Med. 2019 Dec;55(6):783-791. doi: 10.23736/S1973-9087.19.05263-8. Epub 2019 Sep 4. 
5. Mi Yang JeonHyeonCheol JeongSeungWon LeeWonjae ChoiJun Hyuck ParkSa Jin TakDae Ho ChoiJongeun Yim. Improving the quality of sleep with an optimal pillow: a randomized, comparative study. Comparative Study Tohoku J Exp Med 2014 Jul;233(3):183-8. 
doi: 10.1620/tjem.233.183. PMID: 25008402 DOI: 10.1620/tjem.233.183 
6. Michael C. Levin, MD College of Medicine, University of Saskatchewan. Entumecimiento, Última revisión completa feb 2019
Manual Merck, versión para público en general,-medulares-y-nerviosas/s%C3%ADntomas-de-los-trastornos-cerebrales-medulares-y-nerviosos/entumecimiento#v661257_es
7. Jerrold M. Gorski, MD. Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow. J Am Acad Orthop Surg Glob Res Rev. 2019 Aug; 3(8): e082. Published online 2019 Aug 2. doi: 10.5435/JAAOSGlobal-D-19-00082. PMCID: PMC6754212. PMID: 31592507
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