What is the best sleeping position?
Posted Thursday, June 18, 2026 by Brunswick Chiropractic. Filed under General
Key Takeaways
- The best sleeping position is the one that supports you and helps you stay asleep.
- Side sleeping + a pillow between the knees suits many people with back pain.
- Back sleeping + a pillow under the knees can help some people feel more comfortable.
- Stomach sleeping often aggravates neck/upper back stiffness due to head rotation.
- If pain persists, improving sleep quality may help reduce the overall impact of ongoing pain.
Do you wake up with back pain, neck stiffness, or shoulder tension after sleeping?
You’re not alone — and it doesn’t always mean something is “wrong” with your back. Often it’s a mix of sleep position, pillow/mattress support, and how your body’s been loaded during the day (desk work, stress, training, parenting… all of it counts).
We’ll break down the main sleeping positions (side, back, stomach), who they tend to suit, and simple ways to make your setup more comfortable. And if pain has been lingering, sleep quality matters too - research suggests sleep disturbance and persistent pain can influence each other.
Why is sleep important (especially if pain is lingering)?
Sleep is when your body and nervous system do a lot of their “resetting”. If sleep is broken or unrefreshing, many people notice they feel more sensitive, more stiff, and less resilient the next day.
A recent narrative review (Kelleher et al., 2025) summarised evidence that sleep problems commonly coexist with chronic pain, and that sleep disturbance may sometimes precede and contribute to pain persistence. Pain can also disrupt sleep, so it can become a two-way loop.
Practical takeaway: finding a comfortable sleeping position can help, but if pain has been around for a while, it’s also worth improving sleep quality (duration, wake-ups, and how rested you feel). Even small improvements can make a difference over time.
Side sleeping
Side sleeping is the most common sleeping position (often quoted at around 60% of adults). For many people, it can be a comfortable option and may help keep the spine in a more neutral position - especially with the right pillow and support between the knees.
Side sleeping may be helpful for:
- People with back or neck pain (especially if the spine feels well-supported)
- Pregnant women (often more comfortable with a pillow between the knees or a body pillow for support)
- People with reflux/heartburn (GERD)
- People who snore or have obstructive sleep apnoea (in some cases)
Is it best to sleep on your right side or left side?
If you have reflux/heartburn or you’re pregnant, you may find left-side sleeping more comfortable. Otherwise, the best side is usually the one that helps you stay relaxed and asleep.
A practical tip: aim for a pillow height that fills the space between your neck and shoulder so your head isn’t tilted up or dropping down. Some people like a contoured pillow shape, but the main goal is comfort and support.
Possible downsides of side sleeping:
- People with shoulder pain may find the direct pressure uncomfortable
- If your pillow isn’t supportive, you may wake with neck stiffness
- Some people notice more facial pressure on the pillow (and potentially wrinkles)
Back sleeping
Back sleeping can work well for some people because it can make it easier to keep the head, neck, and spine in a more neutral alignment and distribute body weight more evenly.
Back sleeping may be helpful for:
- People who feel better with a neutral spine position
- People who want to reduce pressure on the shoulders or hips
- People who do well with a small pillow under the knees (this can reduce pressure through the lower back for some people)
Possible downsides of back sleeping:
Back sleeping may be less suitable for:
- People with reflux/heartburn (GERD), as symptoms can feel worse lying flat
Quick takeaway: If you’re prone to reflux, lying flat can make heartburn feel worse — many people find side sleeping (often the left side) or gentle head elevation more comfortable.
Why: when you’re horizontal, it can be easier for stomach contents to move upward, and night-time swallowing/saliva tends to reduce, which can make symptoms more noticeable. - Pregnancy (particularly later pregnancy — many people are advised to side sleep)
- Snoring / sleep apnoea: some people find symptoms worsen on their back
- Some types of back pain: a pillow under the knees can help, but it may not suit everyone
- Older adults may find it harder to get in and out of bed in this position
Stomach sleeping
Stomach sleeping is the least common position (often quoted around 10% of people). It’s generally the least recommended for back and neck comfort because it usually requires turning the head to one side, which can place sustained rotation through the neck and upper back.
One possible benefit:
- Some people feel it may reduce snoring (though it isn’t a treatment for sleep apnoea)
Why it may be less comfortable:
- It can increase strain through the neck and upper back
- It can increase pressure through the lower back depending on mattress firmness
- It may place more pressure on the face against the pillow
Pregnancy: stomach sleeping is usually uncomfortable and often avoided as pregnancy progresses. Using pillows for support (for example, a body pillow) can help you stay on your side and reduce the chance of rolling onto your stomach overnight.
If you’re a stomach sleeper and it’s the only way you can fall asleep, small adjustments (like a thinner pillow or a pillow under the hips) may make it feel more comfortable — but many people do better transitioning toward side sleeping over time.
How to choose the best sleeping position for you
There isn’t one perfect sleeping position for everyone — the “best” position is usually the one that helps you feel supported and lets you stay asleep with fewer wake-ups.
A simple way to choose is to start with your main symptom:
- Back pain: many people do well on their side (with a pillow between the knees) or on their back (with a small pillow under the knees).
- Neck pain or headaches: focus on pillow height so your head isn’t tilted up or dropping down.
- Shoulder pain: side sleeping can be uncomfortable if you’re lying directly on a sore shoulder. Some people do better on their back, or on the non-painful side with extra pillow support.
If you’re not sure where to start, try one change for 7 nights, then adjust one variable at a time (position, pillow height, or support pillows).
Pillow and mattress setup tips (quick wins)
Small setup changes can make a big difference to comfort.
Pillow tips
- Side sleepers: A pillow that fills the space between your neck and shoulder often helps keep your neck more neutral.
- Back sleepers: A slightly lower pillow often works better than a very high one.
- If you wake with neck stiffness, try adjusting pillow height first before changing everything else.
Support pillow tips
- Side sleeping: Try a pillow between the knees to reduce twisting through the lower back and hips.
- Back sleeping: Try a small pillow under the knees to reduce pressure through the lower back for some people.
Mattress tips
- If you feel like you “sink” and twist, you may need more support.
- If you feel pressure on your shoulder/hip, you may need more cushioning.
- The “best” mattress is the one that helps you stay comfortable and asleep — there’s no one perfect type for everyone.
Sleep and chronic pain: what the research suggests
If pain has been hanging around for a while, sleep isn’t just “rest time” - it can be part of the picture.
A 2025 narrative review (Kelleher et al.) summarised evidence that sleep problems commonly coexist with chronic pain, and that sleep disturbance may sometimes precede and contribute to pain persistence. Pain can also disturb sleep, so it can become a two-way loop.
Practical takeaway: finding a comfortable sleeping position can help, but improving sleep quality (duration, wake-ups, and how rested you feel) may also reduce the overall impact of persistent pain over time.
References
Kelleher EM, Wall A, Seymour B, Irani A. Why sleep matters in chronic pain: evidence across the lifespan. Pain Reports. 2025. PMCID: PMC12988550; PMID: 41708400. https://pmc.ncbi.nlm.nih.gov/articles/PMC12988550/
Frequently Asked Questions about Sleeping Positions
Q. Is there one best sleeping position for back, neck, and shoulder pain?
A. There isn’t one perfect position for everyone. The best position is usually the one that feels comfortable, supports your joints, and helps you stay asleep with fewer wake-ups.
Q. Is side sleeping always best for back pain?
A. Not always. Many people do well on their side, but some prefer back sleeping - especially if shoulder pain or hip pain is an issue. Support pillows can make a big difference.
Q. Should I sleep on my left or right side?
A. If you have reflux/heartburn or you’re pregnant, you may find left-side sleeping more comfortable. Otherwise, choose the side that helps you relax and stay asleep.
Q. What pillow height do I need?
A. A helpful starting point is a pillow that keeps your head level — not tilted up or dropping down. Side sleepers often need a higher pillow than back sleepers.
Q. Why do I wake up sore even if I fall asleep feeling fine?
A. It’s not always just position. Day-to-day factors like desk work, stress, training load, lifting/parenting, and how much you moved can all add up — then you notice it most when you wake up. Pillow/mattress support matters too
Q. How long should I trial a new sleeping position?
A. As a general guide, it can help to trial one change for around a week (if it’s comfortable and safe for you), then adjust one thing at a time. That makes it easier to tell what’s actually helping.
Q. Can stomach sleeping cause neck pain?
A. It can for some people, because the head is usually turned to one side for long periods, which can irritate the neck and upper back.
Q. When should I get this checked?
A. If you’re waking with pain most days for 2–3 weeks, symptoms are worsening, or sleep is consistently disrupted, it’s worth getting personalised advice.
About Brunswick Chiropractic
This article was written by the clinical team at Brunswick Chiropractic, a Melbourne clinic focused on evidence-based care for spinal health, movement, and musculoskeletal injuries.
Our practitioners regularly work with people experiencing back pain, headaches, migraines, sports injuries, and movement-related conditions. We aim to provide clear, research-informed information to help patients stay active and move well.