According to viral claims, your sleep position matters more than you might think. They swing between alarmist (‘back sleeping causes sleep apnea’) and fearmongering (‘side sleeping leads to facial drooping and asymmetry’). While the majority veers into hyperbole, there is a more nuanced conversation worth having.
For many, the healthiest position is the one that allows the body to relax and supports uninterrupted sleep. But while comfort is crucial, physiology still matters, says Dr Chad Eldridge, sleep and wellbeing advisor for Hästens. “Certain positions may aggravate snoring, reflux, pressure points or existing musculoskeletal concerns,” he explains. Therefore, it pays to think personally. For those snoring-prone, for example, side sleeping may be preferable.
The relationship between sleep position and snoring – particularly in those with obstructive breathing issues or symptoms of sleep apnoea – is well-established. “Sleeping flat on the back can allow the tongue and soft tissues of the airway to relax backwards, which may narrow the airway and increase snoring or breathing disruptions,” Dr Eldridge says. Side sleeping, by contrast, “can help keep the airway more open”. Nicole Moyen, director of science and clinical research at Eight Sleep, adds that this can also reduce jaw clenching compared to back sleeping, “decreasing nighttime teeth grinding”.
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There are also digestive benefits to sleeping on your side. “Gravity helps move stomach contents through more efficiently, accelerating gastric emptying and reducing bloating,” Moyen explains. And for those who are pregnant, sleeping on the left is recommended as it optimizes blood flow to the placenta, she says.
Then there’s the emerging – though yet unproven in humans – idea that side-lying may support better brain waste clearance during sleep. A 2015 rodent study found that the position enabled more efficient glymphatic clearance than sleeping on the back or stomach, including that of amyloid-beta, a protein associated with Alzheimer’s disease.
Of course, side sleeping is not a ‘perfect’ option. “It concentrates body weight on the lateral shoulder and hip, potentially causing pain or numbness if your mattress lacks adequate pressure relief,” Moyen says. “Sleeping on the same side can also create postural imbalances over time.” For this reason, back sleeping is often considered the most spine-friendly position. Here, “weight is distributed evenly across your entire spine, which reduces pressure on any single point and allows your intervertebral discs to decompress overnight,” she goes on to explain. “For acid reflux, sleeping on your back with your head slightly elevated is particularly effective.”
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And yes, pillow wrinkles are a real thing – and one which back sleeping can help avoid. “Sleeping in a repeated position, due to the frictional forces, can lead to changes on that particular side, including an increase in the number or wrinkles on the face, neck, and décolletage,” explains founder of The Soni Clinic, Dr Ash Soni, who can normally tell at the time of a consultation which side a patient sleeps on. Still, the plastic surgeon and aesthetic injector cautions that genetics and baseline facial asymmetry also play a major role, while Moyen adds that sleep quality likely matters more than sleep position when it comes to visible signs of aging: “Poor sleep elevates cortisol, which breaks down collagen, and reduces the release of growth hormones during deep sleep, which is critical for tissue repair and skin regeneration.” In other words, when it comes to skin, great sleep on your side is better than poor sleep on your back.
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If you want to change a long-standing habit, stomach sleeping is the position often flagged by sleep clinicians as the one worth addressing. As “the most mechanically demanding position for the body”, Moyen says, it places strain on the neck and lower back and can make breathing harder because the chest and diaphragm are compressed. Altering sleep patterns takes time, though, and the nervous system needs to relearn what feels comfortable and safe. To help nudge the body into a new position overnight, Dr Eldridge suggests trying physical barriers like specialist pillows and wedges, or even vibration alarms and wearable position trainers. “Expect the process to take a few weeks and try not to switch back and forth during that period, since consistency allows your body to fully adapt,” Moyen adds.
Beyond position, sleep hygiene strongly affects sleep quality. Regularity, a cool, dark and quiet environment, and reduced screen use before bed all matter. As do your mattress and pillow, adds Moyen: “sustained pressure points from a poor mattress can cause micro-awakenings you won’t consciously register, but which fragment your sleep and reduce the time spent in deep and REM stages.” Ultimately, it’s about finding the best set-up for your needs, concludes Dr Eldridge. “Better sleep posture is less about one universal product, and more about creating an environment that allows the body to remain comfortable, supported, and undisturbed throughout the night.”
