Experts agree that sleeping on your stomach is the worst overall sleeping posture. Stomach sleepers often arch or hyperextend the spine, which can lead to tight muscles and low back pain. In addition, many stomach sleepers strain their neck by turning their head to one side to breathe. It is also common for stomach sleepers to contort other parts of their body, such as by bending a knee upward, in ways that can put undue pressure on muscles and joints. Despite these concerns, all is not lost for stomach sleepers. For many, lying on the belly is simply the most comfortable position, and finding a comfortable sleeping position is crucial to a good night’s sleep. Sleeping on your stomach can also help open the airway and reduce snoring. It’s not a foregone conclusion that stomach sleepers will suffer from back, neck, or joint pain. By choosing an appropriate mattress and pillow, stomach sleepers can help to align their body in a way that reduces the risk of these problems. Finding a comfortable mattress is critical for anyone, but it’s especially important for stomach sleepers.
A well-selected mattress can help avoid the pitfalls of joint and muscle pain in this sleeping posture. Experts from the UCLA Ergonomics Program recommend that stomach sleepers choose a firmer mattress. This firmness helps to ensure adequate back support and alignment. An ergonomic study found that stomach sleepers on sagging mattresses have worse spine positions and poorer sleep outcomes. This is because your midsection sinks without adequate firmness, exacerbating spinal misalignment. For this same reason, it is also important to choose a high-quality mattress since a poorly-constructed one is likely to sag in the center with extended use. What feels right in terms of firmness depends on every individual, but generally it is recommended to select the firmest mattress that you find comfortable. Firmness is commonly rated on a 1-10 scale with 10 being the equivalent of sleeping on concrete. Most people prefer a mattress with a firmness level between 4 and 7, but stomach sleepers likely want to aim toward the higher end of that range.
There are several types of mattresses that stomach sleepers can consider: Memory foam, also known as viscoelastic foam, contours to the body and can help provide more tailored support for the whole body. Memory foam mattresses typically have multiple layers of different types of foam. One of these these layers is usually a denser foam that prevents sinking too deeply into the mattress. However, a poorly constructed memory foam mattress or one without adequate foam density could sink far too much for a stomach sleeper. In addition, the contouring effect of memory foam causes some people to find them too warm. Contouring can also make it harder to move around or adjust sleeping positions through the night. Innerspring mattresses use coils inside the mattress to provide spring and support. The coils respond to pressure from your body weight, and the thickness and number of coils helps determine the firmness of an innerspring mattress. While they offer consistent support from the coils, these mattresses typically provide less body-contouring and can create pressure points including near the neck, shoulders, back, and tailbone.
Latex mattresses are made from either natural or synthetic rubber. This material bounces-back more than memory foam and generally provides a firmer feel. This can be perfectly supportive or too firm depending on the individual. Hybrid mattresses include elements of memory foam, coils, and/or latex. A common type of hybrid has a layer of memory foam on top of a base of innerspring coils. For many of these models, though, the foam layer is too thin to add additional support. For any hybrid, it is important to look closely at the composition of the different layers of the mattress. Airbeds use chambers in which air can be added or removed, allowing them to be constantly adjusted to fit the sleeper’s preference. While this offers flexibility in setting firmness, the downside is that many people under-inflate their airbeds or find that they have to make adjustments in the middle of the night. Knowing about these mattress types is essential, but remember that no single mattress type is best for everyone.
Within each category there are many levels of firmness and quality of construction. Choosing the right mattress is only step one. Proper pillow selection is also essential for stomach sleepers. Keeping a neutral spine helps to avoid joint and muscle pain. For people sleeping on their stomach, this means limiting the elevation of their head from the mattress. Using no pillow, only a small pillow, or a pillow only under the forehead can help to keep your head level with the rest of your body. The proper pillow height is also affected by the firmness of your mattress. The more that you sink into a mattress, the more misaligned your spine is likely to be if you use a tall pillow. Pillows can also be used under other parts of the body to help stomach sleepers achieve a neutral spine. For example, a pillow under the chest or under the pelvis and lower abdomen can improve spine alignment when sleeping on your stomach. For most people, pillows that adjust to the body or to pressure are most comfortable.
Cervical contour pillows and memory foam pillows are both options that can provide quality support. As with mattresses, though, what’s best for any individual depends on their own body size and shape. Want to read more about sleeping posture and tips for stomach sleepers? These online resources can help. Better Sleep Council: Sleep Positions. This page provides an overview of the most common sleeping positions. National Sleep Foundation: The Best Sleep Position for Your Body. Learn about the pros and cons of each of the most common sleeping positions. University of Utah Health Care: Good Sleeping Posture Helps Your Back. Review key factors that affect sleep posture including your alignment, mattress, and pillow. Lifehacker: How to Sleep Comfortably in Any Position When You Have Back Pain. This article describes how people with back pain can optimize their sleeping posture. Harvard Health Publications: Say “good night” to neck pain. Read about how your sleeping posture can help you avoid waking up with a sore neck.