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Tips on Sleep Posture, Pillow Placement and More

We don’t often think about our spines when we’re lying in bed. But our sleep posture can determine our spine wellness – and whether or not we experience back pain. So when we turn in for the night, it’s wise to remember these tips from the Cleveland Clinic Center for Spine Health:

Keep your spine in a neutral position

You can accomplish this by changing from an innerspring mattress (shown below) to a foam mattress, altering your sleep position or using pillows.


An innerspring mattress can create pressure points at the back of the head, the shoulder blades, the tailbone and the heels, and won’t support the curve of your spine at the neck or lower back.

Sleep on your back or side

This places less pressure on your back than sleeping on your stomach. That’s because your weight is evenly distributed across the widest surface of your body, minimizing pressure points and ensuring proper alignment of your internal organs.

Alternate sides if you’re a side sleeper

Some evidence suggests that habitually sleeping on one side on an ill-fitting mattress may contribute to muscle imbalance and pain. Always sleeping on the same side suspends the middle of your body between your hips and shoulders, the broadest parts of the trunk. Place a pillow between your knees as shown below to keep hips, pelvis and spine aligned.


When you sleep on your side, notice how hip alignment changes with and without a pillow between your knees.

Use a pillow

Whichever sleep position you choose, position your pillow beneath your head and neck, and not your shoulders. If you sleep on your back, make sure the pillow fills the space between your neck and the mattress to maintain your head in neutral position, as illustrated below. If you sleep on your side, use a thicker pillow, also shown below.


When sleeping on your back, keep your neck properly aligned by filling the space between your neck and the mattress with a pillow. When lying on your side, use a thicker pillow and place it under your ear.

Your body type dictates the type of support you need

If your hips are wider than your waist, a softer mattress can accommodate the width of your pelvis and allow your spine to remain neutral, as shown below. If your hips and waist are in a relatively straight line, a more rigid surface offers better support.


Sleeping on a rigid surface (top) versus a softer surface (bottom) affects the position of the pelvis and lower spine.