The Ergonomics of Sleep – Finding the Right Position

Choosing the best mattress and pillow combination is essential when searching for the perfect sleep equation, but the position in which you put yourself in may be just as important.   Putting your body into the correct anatomical position will allow the mattress to perform to the best of its design (hopefully offering both comfort and support).

Improper sleep positions and mattresses that do not offer the proper support or pressure point relief can cause physical pain, numbness and lingering, long term conditions.   If you have spent or are about to spend several paychecks on a mattress, you certainly should fully understand the anatomy of the proper sleep position to let the mattress do its work.   The following recommendations will help you achieve the best sleep, recovery and support necessary to maintain a healthy frame and promote all the wellness benefits of a good night’s rest.

There are three primary sleep positions and most individuals will change their position several times over the course of a full sleep cycle.   These positions are back, side-lying and stomach.   The key is to program yourself to maintain control of your positioning during a period in which your body is not conscious.   This can be achieved through creating good habits and programming the mind in advance of the desired position to maintain.   Breaking old habits may require the use of body pillows and aids to hold the position until the programming is established.

When evaluating the best sleep positions, it is best to look toward the natural curvatures of the spine in all planes.   The sleep positions in order of worst to best are as follows:

Make every effort NOT to sleep on your stomach.   This position forces the neck and upper back to rotate in order to keep breathing passages open.   This creates repetitive stress on the muscles, ligaments and discs within the neck.

Side-lying sleep positions can be acceptable and comfortable and often necessary with apnea and chronic snoring.   The key is to avoid bad habits that put the spine into rotation and imbalance.   Be sure to pull the pillow tightly into the shoulder so that the width of the shoulder is supported and the head stays on plane with the rest of the spine.   Pillow height is essential to maintain this position and will change with width of the shoulders and softness of the mattress.   Also, make sure that the pillow and shoulder position is set to avoid rotating or tucking the shoulder forward.   The shoulders should maintain a perpendicular position with relation to the mattress to alleviate rotational stress.   This also applies to the hips and pelvis.   This can be achieved by putting a thin pillow between the knees to maintain pelvic width and by ensuring that the knees are together and flexed at the exact same angle.   The proper support system within a mattress will absorb the wider, heavier segments and conform into the lighter segments balancing weight distribution across the entire frame.

Back sleeping offers the best opportunity to maintain a sleep posture.   Keeping the spine straight and out of rotation is easily accomplished in this natural position.   The proper positioning and height of the pillow is important to support the natural extension (lordotic) curvature of the neck.   Back sleepers typically require a very thin pillow or soft neck roll.   Orthopedically engineered mattresses will allow the heavier, kyphotic curves to absorb into the mattress and conform back into the lordotic curves of the neck and lumbar spine.

Finding the proper sleep position reduces stresses on the joints and sensitive bony segments in the shoulders and hips.   A comfortable and anatomically correct sleep position will result in less tossing and turning and thus a deeper, more restorative sleep pattern.   This is necessary for several homeostatic (self-regulatory) mechanisms within the body including healing, stress reduction, bio-chemical balance and energy.   The body does most of its regeneration of tissue during deep levels of sleep and having proper position of the extremities, spine and head lead to the most stable and healthy outcomes.   Find yourself the ideal, orthopedically engineered mattress and train yourself to hold the healthy positions described in this article and end the cycle of waking up in pain and discomfort.


Dr. Rob Schroeder is President and CEO of Innate Sleep Orthopedic Sleep Systems and designed the premier orthopedic mattress in the industry with sales primarily in health professional office settings. This mattress has been chosen by PGA Tour professionals, athletes and top physicians as their choice in sleep systems. He is also CEO of Indy Health and Fitness, a multi-service sports performance and rehabilitation center in Indianapolis, Indiana. In addition, he continues to maintain a thriving Chiropractic practice with a patient list of some of the most recognizable names in professional athletics and motor sports. Indy Health and Fitness Center is a destination for motor sports performance and fitness and serves as a staple for athletic development at all levels. Educational background is a bachelor in Kinesiology, Masters level work in exercise physiology and Chiropractic Doctorate from Palmer-West. He is a sought after speaker in the seminar circuits and has several published trade related articles in the topics of sleep health and exercise physiology. He also serves on many advisory and executive boards for his knowledge and experience in health care and sports performance.

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