Key Points
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The best sleeping position for your body depends on your physical condition, but experts generally advise against sleeping on the stomach.
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Some Asian traditions hold that the compass direction you're pointing at during sleep affects health.
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There are psychological theories about what your sleeping position means for personality and relationships, but the evidence for them varies.
If you're getting enough sleep, you spend a third of your life in bed, so your sleeping position matters. It's the difference between waking up feeling refreshed and waking up with a killer backache. Some also say that what compass direction you sleep in also affects your health; others say that your sleep position says something about your personality and (if you sleep with a partner) the nature of your relationship.
Given all that, what's the best sleeping position for you? What does the science say? Read on to find out.
Sleeping Position and Your Body
Children sleep in every position, but as they get older, they usually settle into one or two favorite positions. Which position is best depends partly on your physical condition and needs.
Sleeping on Your Back
Sleeping face-up is comfortable and healthy for most people. It's especially helpful if you have lower back or neck pain because your spine is naturally straight in this position. (A supportive mattress or firm mattress topper also helps.) Back sleeping also encourages post-nasal drip in people with sinus or nasal congestion, especially if they elevate their heads slightly with a wedge pillow. Finally, keeping your face off the pillow avoids pulling and friction, which encourage wrinkles.
Still, doctors recommend against back sleeping for certain people. It harms blood circulation in heavily pregnant women, and it aggravates snoring and sleep apnea. Obese people often find it hard to breathe while lying on their backs. There's also some evidence that back sleeping worsens acid reflux.
If you suffer from back pain or sciatica and find sleeping on your back uncomfortable, putting a thin pillow under the curve of your waist or your knees sometimes helps get your spine in the proper alignment.
Sleeping on Your Side
Side sleeping is popular among adults, and it has a few variations. Sleeping curled up in a fetal position often helps people with back pain because it stretches the back muscles. Experts recommend this position for pregnant women. A more stretched-out side position is fine for most people, and it lowers the risk of snoring and other breathing problems compared to back sleeping.
Is one side better than the other? Pregnant women should favor the left side because it puts less pressure on the liver, and some research suggests that left-side sleeping is better for acid reflux due to the configuration of the digestive tract.
Use pillows to ensure your spine aligns for the healthiest side sleeping. Side sleepers need thicker pillows under their heads to keep their necks straight, and a body pillow in front helps keep the back from twisting. A thin pillow between the knees often helps those with back pain.
The only drawback to side sleeping is that it puts pressure on the shoulders, especially if you have broad shoulders in proportion to your body (as many men do). This is more of a problem if you have a firm mattress, so side sleepers do better with slightly softer mattresses than back sleepers.
Sleeping on Your Stomach
Some people like sleeping on their stomachs, but it's the least favorite position of healthcare providers because it so often causes back and neck problems. In fact, sleep posture specialist James Leinhardt went viral on TikTok with a video demonstrating the effects of stomach sleeping with a plastic skeleton.
"You’re rotating your neck, you’re twisting it,” he said. “You’re putting your head up and you’re fighting all the natural curves of your spine."
The one advantage to it is that you're least likely to snore in that position.
A body pillow is one way to wean yourself from stomach to side sleeping. Side sleeping isn't always at a perfect 45-degree angle from the bed — sprawling across a body pillow lifts one side of your body and helps align your spine without putting all your weight on your shoulder and hip.
If you must sleep on your stomach, it's best to use a firm mattress and a thin pillow (or no pillow). This helps prevent the spine from bending at the waist.
Does It Matter Which Direction You Point During Sleep?
The impact of back, side, or stomach sleeping on the body is easy enough to understand, but there's a more esoteric realm of beliefs about which compass direction you should point while sleeping. Those beliefs are bigger in Asia than in the West, as they stem from theories about the health effects of architecture that arise from Eastern ideas about energy fields.
Vastu Shastra
In the Indian subcontinent, this mystical architectural theory is vastu shastra. Among its beliefs is that the human body has its own north and south "poles," and for good health you need to line it up with the Earth's magnetic poles while you sleep. On this theory, you should never sleep with your head pointing north, as it causes tension and sleep disturbances. The best direction to sleep is with the head pointing south, although pointing east is also thought to have benefits.
That might sound a little woo-woo, but the idea that the earth's electromagnetic field affects your body makes some sense — after all, your brain and nervous system also run on electrical waves. Research indicates that cattle and deer naturally orient themselves north-south for eating and resting, and one study conducted by researchers Amin Hekmatmanesh et al. found that nappers lying on a north-south axis had better sleep quality than those on an east-west axis.
That study doesn't indicate whether pointing north is bad since it only compared sleepers with heads pointed south to those with heads pointed west. Still, it does lend some intriguing support to the idea that electromagnetic alignments affect sleep.
Feng Shui
Feng shui is the Chinese equivalent to vastu shastra — you've probably heard of it regarding things like furniture arrangements. Feng shui alignments also favor the south and general north-south alignments of buildings. Another characteristic of feng shui is the arrangement of the bedroom: You should put the bed against a wall opposite the door, or failing that, place a mirror so that you can see the door when you're in bed. The idea is that seeing the door at all times gives you a feeling of command.
Feng shui practitioners are also concerned about electromagnetic interference with sleep, although it takes the form of keeping electronics out of the bedroom. At the same time, they believe that plants in the bedroom transform negative energy into positive. Western sleep specialists tend to agree with those recommendations, though for different reasons: Electronic devices are over-stimulating, and plants are calming and help keep the air fresh.
The Psychology of Sleeping Positions
Another idea about sleep positions that you might have encountered online is that they reveal something about your deep character, like a Rorschach test or a horoscope. This idea goes back to the 1977 book Sleep Positions: The Night Language of the Body by psychiatrist Samuel Dunkell. Dunkell divided sleep positions into more granular categories than "on the back" or "on the side" He gave them catchy names relating to their associated personality traits.
Full Fetal and Half Fetal
You've already seen the fetal position discussed for its health qualities, but Dunkell further divided it into full fetal (in a tight ball) and half fetal (limbs bent but more loosely). In his observation, full-fetal sleepers were sensitive, nervous, artistic types, while full-fetal sleepers were mellower and more easygoing.
Prone
"Prone" is what Dunkell called sleeping on the stomach, usually with the arms around the pillow. In his view, prone sleepers are compulsive, stubborn, and rigid.
In 2003, a different sleep researcher, Chris Idzikowski, identified this position with people being bold and sociable on the outside but sensitive on the inside.
Royal
The royal position is simply lying on the back with arms slightly spread. Dunkell associated this position with independence, confidence — even arrogance. Bed partners tended to resent this position because royal sleepers don't make space — though an even more intrusive version is the "starfish," with arms and legs splayed out.
Idzikowsi, however, said that starfish sleepers are actually good friends and listeners and are averse to drawing attention to themselves. He distinguished them from the more reserved "soldier" sleepers, who keep their limbs close together while sleeping on their backs.
Spoon
In addition to the sleep positions of individuals, Dunkell and other researchers have also studied the sleep positions of couples and what they say about their relationships. The spoon is a familiar one even to non-specialists: the side-sleeping position where one partner — usually the larger one — embraces the other from behind. It's not a terribly common position, but it happens most often in the couple's first five years together.
Loose Spoon
The loose spoon is just what it sounds like — a spoon with a little space between the partners. British physician Diana Gall said that transitioning from a tight spoon to a loose spoon is normal: "It still provides that closeness and reassurance. But there’s more space between you, allowing you to breathe and relax into a comfortable position."
Back Kissing
Back kissing is when the couple lies back to back but still touches — sometimes with their backs, though usually with their buttocks. This allows a bit of contact with more independence than the spoon (and is also less sweaty on warm nights).
Liberty Lovers
This is another back-to-back position, but with no contact — hence the liberty. This can signal distance in a relationship, but it also tends to happen when a couple has been together for a long time and no longer need the reassurance of constant contact.
Is There Evidence for Any of This?
Various researchers have tried to replicate Dunkell's findings over the years — with mixed results. Problems include defining each sleep position (since people come up with countless small variations) and measuring the relevant personality traits. As a result, most psychologists and sleep experts don't see sleeping positions as very relevant to a person's mental state.
There is some evidence that sleep positions say something about a couple's relationship. In a large 2014 survey, British psychology professor Richard Wiseman found a correlation between conjugal happiness and contact in bed.
"One of the most important differences involved touching, with 94% of couples who spent the night in contact with one another were happy with their relationship, compared to just 68% of those that didn't touch," Wiseman said. He also found that the farther apart they slept, the less happy they were.
Sleep the Way That Works for You
As you can see, sleeping positions have been the subject of a remarkable amount of theorizing and analysis over the centuries. Such analysis is interesting and sometimes entertaining, but ultimately you should listen to your body — no two physiques are precisely the same, so you know what's best for you.
The same goes for relationships. Although happy couples tend to snuggle a lot, sometimes sleeping apart or even in separate bedrooms is best for domestic harmony, especially if one partner is constantly disturbing the other's sleep. Use whatever information you find here that makes you happier and healthier, but don't lose sleep over your sleeping position.
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