Sleep: 101
Judging by the number of questions we regularly get from patients, proper sleep seems to constantly be at the forefront of nearly everyone’s mind. How can something meant to be relaxing and recharging cause us to wake up, curse the alarm clock, and reach for the pills to dull the pain in our neck or lower back? Few things are as essential to our overall health (and mood) as sleep. While we will save the discussion on “Sleep Hygiene” for a future post, let’s take an in depth look at the mechanics of sleep, ideal positions, mattresses, and general tips for helping your mornings suck just a little less.
The Great Position Debate
First and foremost, it is most important that we’re actually sleeping. If the only way you’re able to sleep is by contorting yourself in a Tetris block-like position, fitting yourself around pets or stubborn children, on top of a fort’s worth of pillows, then do it (and find a good chiropractor). Changing your preferred sleep position can be a challenge, but it is worth the effort to avoid chronic aches and pains, especially as we age. Let’s break down the ideal sleep positions from a purely biomechanical standpoint:
1) Back Sleeping
The gold standard of sleep positions. In terms of support and alignment, it’s hard to beat back sleeping.
Pros: Keeps your spine in a neutral position, reducing the risk of back and neck pain. Also, it can help minimize acid reflux if you elevate your head slightly.
Cons: Snoring. Lots of snoring.
2) Side Sleeping
A solid 2nd place option for a lot of people. Your choice of mattress and pillow get a bit more important, but it can be a reasonably supportive position for sleep.
Pros: This position is great for reducing snoring and is often recommended for pregnant women. It can also help keep your spine aligned with the proper mattress and pillow set-up
Cons: It can lead to shoulder and hip discomfort, especially if your mattress isn’t up to snuff.
3) Stomach Sleeping
Some of you will not like to hear it, but anything is better than stomach sleeping. The pressure it puts on your joints can really catch up to you over time.
Pros: Well... it’s good for… Hiding from your responsibilities?
Cons: Honestly, this one’s not great for your back or neck, and it can lead to aches and pains when you wake up. If you must sleep on your stomach, try placing a pillow under your hips to reduce strain.
The Mattress Matters
If you are a regular patient, you’ve probable heard this before:
“Your shoes and your bed; if you’re not in one, you’re in the other”.
The point being that of all the things you own, it’s worth putting a little thought (and maybe a little extra $) into the shoes you walk in and the mattress you sleep on.
It may seem like a bit of a cop-out, but the most important thing to consider when choosing a mattress (just like your sleep position) is your ability to sleep. If it makes sense on paper, but keeps you from sleeping soundly, always choose sleep. Also look for one with a decent trial period and return policy, usually 90-100 days at least. We often need a period of acclimation before deciding if a particular mattress is going to work, so give it some time.
That being said, here are some tips to consider when choosing a mattress:
Firmness: This is highly personal. Some folks need a firm mattress to support their spine, while others prefer something a bit softer. The key is to find one that keeps your spine aligned without creating pressure points. In general, dedicated stomach sleepers should consider something firm, side sleepers more in the medium range, and back sleepers can go either way.
Material: Memory foam, innerspring, hybrid—there are a lot of options on the market to consider. Each material has its pros and cons. Memory foam is great for pressure relief but can get hot. Innerspring offers good support but may not conform to your body as well. Hybrids combine the best of both worlds.
Age: Mattresses have a lifespan, usually around 7-10 years. The number one way to determine if your mattress needs to be replaced is the presence of any kind of dipping or sagging. You might just think that it’s sufficiently “broken-in” but trust me. It’s gotta go.
So, there you have it. Sleep can and should be restful and recharging, not a source of pain. There can be a lot of trial and error when it comes to improving your sleep, but it is so worth it. And, just in case you were curious: side sleeper, medium hybrid mattress, light-density memory foam pillow, another pillow between the knees. Works like a charm for me.