How did you sleep last night? If you’re like most people, you assumed your favorite position at bedtime. But once sleep sets in, you likely moved again and again, shifting into multiple positions as you slept.
If you wonder whether there’s an ideal way to sleep, you’re not alone: There’s plenty of conflicting advice and dubious online information linking sleep positions to various benefits or problems, and the market is flooded with devices that promise to keep you from sleeping on your back, the scapegoat of most sleep position science.
But it turns out we have way less control over how we sleep than we might think—and we might be better off not trying.
(These are the mysteries that science is unlocking about sleep.)
“Sometimes there’s more harm than good in trying to control your position,” says Raman Malhotra, past president of the American Academy of Sleep Medicine and a professor of neurology at the Washington University School of Medicine.
Here’s what we do know about sleep positions—and what sleep scientists say is worth focusing on for a good night’s sleep.
Debunking early sleep theories
Are you a Flamingo, a Dutch Wife, or a Royal? The question isn’t part of a party game, though it might sound like it. Those colorful monikers are used to describe the seemingly limitless ways in which our bodies arrange themselves while sleeping.
They’re just a selection of the terms coined by psychologist Samuel Dunkell, who penned a popular psychology book in 1977 calling sleep positions “the night language of the body.” For Dunkell, sleep positions gave clues about an individual’s personality traits and psychology—their bodily position during their most vulnerable hours offering hints of how they move through the waking world.
This analysis prompted a young Joseph De Koninck, a psychologist in Canada, to wonder how people really sleep at night. He created a stop-motion method for photographing sleep positions throughout the night without waking a patient. This system, based on the Super-8 camera, unleashed a torrent of research on how people sleep.
(Here are seven science-backed tips for better sleep.)
But the psychologist, now an emeritus professor at the University of Ottawa, soon concluded that a person’s position during sleep has nothing to do with their personality, preference, or even sleep stage. Moreover, he says, “The position you take during sleep onset is not necessarily the one you use through the night.”
So what does science tell us about our sleeping positions? De Koninck’s research has showed that the number of times people change position during sleep goes down with age and that older adults strongly prefer sleeping on their right side—a position that could help regulate blood pressure. Meanwhile, other studies show that people tend to spend over half of their sleep time on their sides, with older and obese patients moving less than their younger counterparts.
When sleep gets uncomfortable
After dozens of studies on the topic, De Koninck is now convinced that sleeping position is more a reflection of anatomy and physiology than a person’s psychology—and that once you go to sleep, your body’s in charge of its position.
Malhotra agrees. “There are definitely positions that are more comfortable for certain patients,” he says—for example, an injury in your left leg or shoulder might prompt you to sleep mostly on your right side. But he notes that once a person is sleeping, it can be a long, frustrating road to train people to avoid certain positions during their sleep.
“Controlling someone’s positions at nighttime is very difficult,” he says. The majority of patients who need to change their sleep position are back sleepers experiencing sleep apnea, in which the airway collapses or does not function properly, causing a person to stop breathing multiple times per night.
(This is the toll that sleep apnea takes on the body.)
Some people turn to fancy sleep training devices to keep them off their backs. Though only a few are FDA-approved, these devices buzz, inflate, and poke patients into different sleep positions. Meanwhile others simply tape a tennis ball to their back to make back sleeping uncomfortable, an old-school method that has actually been shown to work as well as special sleep training devices.
Still, training someone to adopt a different default sleep position can take months—and setbacks are common. Studies show that patients tend to abandon both tennis balls and other devices because of the discomfort they cause.
“Some of the devices we recommend are disruptive to patients’ sleep, Malhotra says. And those months of sleepless nights are themselves associated with all sorts of health issues, from obesity and stroke to accidents and depression.
The future of sleep research
Sleep scientists continue to improve the tech behind sleep studies, using accelerometers and other technology to determine sleep position. But the benefits of certain sleep positions are still unclear—and it’s proven difficult to put the information we do have about sleep positions to use.
For example, studies on sleeping rodents suggest side sleeping is associated with better cognition and a lower risk of dementia, perhaps because it helps clear brain waste. But animal studies don’t always translate in human subjects, and even if you managed to train your body to sleep on the side, it’s unclear whether it would benefit your brain health long-term.
Instead of worrying about something that’s so hard to control, Malhotra says it’s worth asking yourself how you feel when you wake up. “Our best measure of sleep quality is still what someone feels like in the morning,” he says. Overall, the science suggests that if you’re well-rested and don’t have sleep apnea or pain, you don’t need to worry about sleep positions. So next time you go to sleep, close your eyes, relax, and let nature take its course.
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