Penned By: Dr. Sagar Kakatkar
Approx. Read Time 7 Minutes
About 1/3 of our life we are on the bed & asleep, yet we know so little about it. Thankfully we are living in a decade which can be described as the golden era of sleep science. Every aspect of the sleep is being studied in great detail and considerable progress is being made. One Arianna Huffington is the flag bearer of this new sleep revolution & has written a fascinating book on this subject. (Sleep Revolution)
Being an Orthopedic Surgeon I will delve on the part of the sleep that matters to us most but about which awareness and scientific knowledge is lacking. It is about sleeping postures.
Every sleeping posture has advantages and disadvantages. One needs to follow the approach ‘Horses for the Courses’ (horses-for-courses Cambridge) while choosing the sleeping postures and while using pillows. Commonly seen sleeping postures are Supine sleeping i.e. Sleeping on the Back, Lateral Sleeping i.e. Sleeping on the Sides, Prone sleeping i.e. Sleeping on the Stomach and fetal positioning i.e. Sleeping on the Sides with Legs and Spine in flexion.
Sleeping on the back i.e. Supine posture has been considered the most physiological positioning for sleeping. Person’s back posture and curvature has to be considered and studied thoroughly while selecting the pillow in sleeping position. A pillow is nothing but a spacer to fill the gap between the mattress and the spine. If you have unmatching spine curvatures and mattresses i.e. a Stiff spine on a stiff mattress, then it can lead to back problems, persistent neck pains, problems like constipation. Hence, it’s important to choose a mattress that is soft to firm but not hard. Also, the pillows should not be too soft or too hard since they have to support the neck or sides of the back to keep the spine in neutral position while asleep. In people with very stiff back curvatures it might be necessary to use additional pillows for supporting the spine. A properly cushioned spine in a supine position of sleeping helps one to get a sound sleep and prevents back and neck problems. This position can have disadvantages like sleep apnea which is common in obese people due to tongue falling back due to gravity and obstructing the respiratory passage leading to snoring. Studies show increased incidence of gastric reflux in patients sleeping in supine position without a pillow.
Sleeping in lateral decubitus position (decubitus+position-dictionary) i.e. sideways as it’s advised in pregnancy, has its own advantages. It does decrease chances of gastric reflux and sleep apnea. But it may not be appropriate in patients with shoulder problems as it can increase shoulder pain. In obese patients there are reports of having nerve palsies due to pressure in lateral positioning. To avoid neck pain and muscle aches, one has to use a firm pillow which can keep the neck of the patient in neutral position when sleeping in lateral position. Sometimes consultants can advise you to use smaller cushioning pillows under the bony prominences to avoid these sorts of problems.
Sleeping in the prone position (Prone Position- Link) Up or on the stomach is a ‘No-No’ position. There are hardly any advantages of sleeping in this position but there are multiple disadvantages such as increase in neck and back pains, Gastrointestinal problems, joint pains. If one has a habit of sleeping in this position, then it ideally has to be changed. The back and neck curvatures can’t be kept in neutral position in prone position thus leading to all sorts of issues.
The Fetal position in which a person sleeps in lateral position with arms and legs flexed with a curved spine may be attained by children. It is not a good position to sleep for adults since it causes excessive stress on the spine and the neck. Hyperflexion of the joints may also cause persistent joint pains, aggravation of arthritic issues.
Although there are a few proponents of sleeping without a pillow, a pillow should be used as a sleeping aid and can help one relax his spine and neck. Adequate mattress size, good firm mattress consistency, frequent change of mattresses i.e. in 8-9 years are also important to have a good night sleep. Sleep although is a phase of relaxation should not be taken lightly as it does affect your health.
An Irish proverb puts it so well, “A good laugh & a long sleep are the best cures in the Doctor’s book”
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