One of the most common topics that comes up in clinic is sleep posture – and for good reason.
Let’s start with the most important point:
💤 Why Sleep Matters So Much
There’s little else that has such a huge impact on your overall health as a good night’s sleep. So when it comes to sleep posture, the goal is simple:
Find the position(s) that allow YOU to sleep well.
⚠️ Debunking Sleep Posture Myths
You may have read online that you must sleep in a certain position to avoid “misaligning” your spine. This is misleading and often causes unnecessary worry.
Here’s the truth:
Your sleeping position won’t structurally change or damage your spine.
Some positions might feel better or worse depending on your body or injury – but that’s about comfort, not alignment.
What works for one person may not work for another – there’s no universal "perfect" posture.
😴 Front Sleepers – Friend or Foe?
You’ve probably heard, “Never sleep on your front!” But…
While it can be awkward for some (e.g. due to neck rotation or lower back compression),
Others – especially those with flexible necks or disc issues – may actually find it comfortable and relieving.
So again, it’s about what works for you.
🧭 Finding the Best Sleeping Position (For You)
If you're sleeping well and not in pain – keep doing exactly what you're doing.
If you're waking up with neck or back pain, then posture is worth paying attention to.
Let’s break it down further:
🤕 Neck Pain & Sleep Posture
You’re likely to be on your side or back (as front sleeping is often naturally avoided).
Things to aim for:
Neck in a ‘neutral’ position – not overly bent or rotated.
On your side:
Use enough pillow height to prevent your head from dropping.
Avoid too many pillows that push your neck too high.
On your back:
Keep the head supported and avoid having it fall too far back (excessive extension).
Flexion vs. Extension:
Imagine standing upright looking ahead = neutral.
Chin to chest = flexion.
Looking up to ceiling = extension.
Many necks dislike being stuck in excessive extension (common when back sleeping with poor pillow support).
Remember, ‘neutral’ is a range, not one fixed perfect position.
✅ A Simple Neutral Neck Test:
While lying on your back or side:
Tuck your chin fully toward your chest (flexion).
Tilt your head as far back as it will go (extension).
Now find the midpoint between those two – that’s a good estimate of neutral.
😣 Lower Back Pain & Sleep Posture
Just like the neck, some backs prefer flexion, others extension.
Common scenarios:
Front sleeping = usually extends the lower back.
Can be painful with joint issues.
Can feel relieving with disc problems.
Back sleeping = generally neutral,
But placing a pillow under your knees can reduce unwanted extension.
Side sleeping (slightly foetal) = good for:
Muscle tightness or spasms (promotes gentle flexion).
Relief from general lower back discomfort.
👉 A pillow between your knees can also help by subtly repositioning your pelvis and lower back for less pain.
🫁 Other Factors to Consider
Snoring or Sleep Apnoea?
Back sleeping can worsen symptoms.
Try side sleeping for better airflow and reduced obstruction.
Morning Pain?
Waking up sore doesn’t always mean your posture is to blame.
Pain can be due to:
Inflammation building up overnight.
Lack of movement.
Natural stiffness in healing tissue.
🛏️ What About Pillows?
This comes up a lot, so here’s my take:
The goal: adequate, consistent support.
Most people do well with:
One large or two smaller pillows.
Memory foam can help because it keeps its shape through the night.
Feather pillows can flatten and lose support.
Orthopaedic pillows?
If you like them, use them.
But you’re not damaging your spine by using a regular pillow – so don’t stress.
🔑 Key Takeaways
Getting a good night’s sleep is one of the best things you can do for your health.
The best sleep posture is the one that helps you sleep well.
If you're having pain:
Pay attention to the flexion/extension of your neck and lower back.
Make small adjustments to find what feels best.
If any of the explanations above were hard to visualise, or you're not sure how they apply to you, please feel free to get in touch – I’m happy to go through it with you in person.
Sleep well,
Shane