Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
2 Jul

How to Improve Your Sleep Posture

sleepingpostureYesterday, I posited that it’s not so much the bedding that matters in making for rejuvenating, nourishing sleep, but rather our sleeping position/posture. Man is the supreme adaptor, having proven himself capable of surviving in just about any natural environment, no matter the climate, topography, and available selection of edibles – and our bedding is no different. Of course, there is a limit to our adaptability. We couldn’t survive in the Antarctic or get a good night’s sleep in a mud pit. Thriving in the current food environment is definitely doable, but, as you well know, it takes a lot of effort to make it work. Luckily, we aren’t dealing with hydrogenated mattresses or high-fructose pillows, so the bedding situation isn’t so dire.

You can keep it pretty simple, in fact: if you’re getting good, pain-free sleep already, hacking isn’t necessary. Just keep doing what you’re doing and keep the bed you’ve got. (Keep reading, though.)

If you’re waking up with pain, though, we should reevaluate. Pain usually indicates an improper sleeping position, and that’s the easiest thing to fix (rather than buying an entirely new bed), so let’s look at some other options.

Sleeping in the supine position with a lengthened spine, as I mentioned yesterday, seems to be the least problematic. It’s relatively easy to attain, and as long as you don’t snore and drive your sleeping partner to retaliatory violence, you should be able to get a good night’s sleep and wake up without pain. I should note that I messed up a small detail regarding the spine lengthening; while I said you should lengthen the spine by pushing with your hands, it’s actually much easier pushing with your elbows. Gokhale’s book goes into far more detail, of course.

Another potential problem with sleeping on one’s back is that some people just can’t get comfortable enough to sleep. It can be rather boring. You can’t spoon your loved one (or a pillow) from that position, and there’s something about splaying out across the bed on your stomach or side that just feels good. Side or stomach sleeping, while satisfying, tends to be a bit more problematic. There’s more room for error.

But the allure is undeniable. It’s almost instinctual, isn’t it, to sleep on your side? I’m a firm believer in listening to your body, and if it’s telling you to sleep on your side, or stomach, maybe you should listen. Just make sure you do it right. Side sleeping is the most popular position worldwide, but many of our musculoskeletal systems have spent their time on earth sitting in bad chairs, hunched over keyboards, and exercising incorrectly in bulky shoes. We might be a bit too “tainted” to launch into instinctual sleeping positions without worry. Side sleeping can often aggravate shoulder injuries, and if you’ve got poor thoracic mobility and a strong tendency toward kyphosis of the shoulder blades, sleeping on either side will exaggerate the kyphosis of that side. If you’re a right-side sleeper, your right shoulder will slump forward all night under your bodyweight. People without kyphosis can probably handle side sleeping without much of a problem – but how many people don’t have some modicum of slumping going on?

Gokhale ‘s book contains a lesson on side lying, which involves lengthening your spine without turning it into a hunch, which is how most people nowadays sleep on their side: in the fetal position with a strong forward curl of the spine. All you folks who like to cuddle pillows, I’m pointing at you. Be wary of the forward curl! She shows you how to maintain the comfort of side lying with bent legs and a straight, lengthened spine. I bet you could even slip a big comfy pillow in there and stick the position.

For you stomach sleepers, physiotherapist Michael Tetley has some interesting observations – and recommendations – based on his time with several groups of African tribesmen. He comes off as a bit wacky, but his observations are useful. His first example is the side lying position. The visual juxtaposition of a mountain gorilla with a Kenyan man is striking, with both subjects lying on their side with impeccable form and long, straight spines.

Next, he recommends sleeping in the recovery position, sort of a half-stomach, half-side sleeping position with the bottom arm looping across the front of the neck to the opposite shoulder for neck support and the outside arm resting gently on the ground or bed. In this position, the bottom leg is positioned as a resting place for the penis to avoid it “[dangling] in the dust…bitten by bugs.” Let’s hope genital-feeding insects aren’t an issue in your bed.

He writes of Tibetan caravaneers sleeping on their shins when the ground is wet and cold, presumably because the lack of significant muscle in the contact areas reduces heat loss. I tried this out and found it initially uncomfortable, but after some fooling around I managed to get into a fairly comfy spot. The key was sitting back with the hips and resting lighting on the forearms, rather than slumping forward and resting on your head. Try it out.

Then there’s the lookout position, where you use your arms as pillows while lying on your stomach. He doesn’t mention what to do with the penis, but I imagine it’s resting on a thigh. This guy is really all about protecting his junk. I guess we all are, though. He’s just honest about it.

My favorite is the quadrupedal lying position. It looks awkward, what with the spine rotation and flexing, but it’s actually pretty darn comfortable. I did have to play around a bit. If you look at the picture, the bottom leg is drawn up pretty closely toward his chest. I found that letting it drop back a bit felt better. Either way, playing with that bottom leg position seems to be key to finding the sweet spot.

It’s interesting that all of the positions he details are couched in utility: protecting the penis from bugs, keeping the ears clear to hear oncoming threats, avoiding cold. In today’s world, most of us rarely, if ever, have to worry about keeping a lookout, or watching for biting bugs, but the fact that our ancestry evolved under similar conditions means that these protective sleeping positions still make sense. Really, though, it’s all about protection. Gokhale’s lying recommendations are designed to protect your musculoskeletal system from degradation and dysfunction, while Tetley’s are primarily about avoiding exogenous dangers (without compromising the body’s form, of course).

Next, I’ll discuss bedding options. Sticking with good sleep posture is most of the battle, but not all of it. In the meantime, let me know about your favorite sleeping positions!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I did the spine-lengthening exercise you mentioned yesterday last night and slept like a baby. Woke up without having moved a muscle all nit, and it felt great. Thanks Mark!

    Uncephalized wrote on July 2nd, 2010
    • I tried this too! It felt very comfortable, and very similar to (if not the exact same as) corpse pose in yoga. Unfortunately my mind was still racing so I didn’t fall asleep right away. Oh well, I’ll try again tonight.

      Bound to Earth wrote on July 2nd, 2010
  2. Oops. That should read “all night”, sorry.

    Uncephalized wrote on July 2nd, 2010
  3. I sleep best on my stomach: left arm over my pillow, right arm underneathe, right leg straight, and with my left leg pulled up to the side. It almost looks as if I’m scaling a rockface with my leg cocked like that haha, but I find that position extremely comfortable :)

    BiggyT wrote on July 2nd, 2010
    • That’s the EXACT description of how I’m most comfortable.

      Rob wrote on July 2nd, 2010
    • ditto

      Peggy wrote on July 2nd, 2010
      • I do that also, Having the leg bent and out to the side takes some of the pressure off my lower back. If I’m flat on my stomach, my lower back arches and start to hurt after a while.

        Jenny wrote on July 2nd, 2010
    • I call it the peacock!

      Jeff wrote on July 3rd, 2010
    • I do the same thing most nights. I did try the spine lengthening suggestion last night and I’d like to say it helped me get to sleep, but the baby had me up until 3am, so I can’t rule out sheer exhaustion. lol.

      When I was pregnant I had to sleep in Recovery Position to avoid the belly and always found knocked-knees to be irritating. Eventually my knees began to enjoy hugging a pillow at night. I was surprised how comfortable that was, but am glad to have more flexibility with my sleep posture these days, like the climber’s position mentioned above. :D

      CriQue312 wrote on July 3rd, 2010
  4. one issue with elbows bent at 90 degrees or more is with ‘ulnar neuropathy’ (the nerve that runs thru the elbow is stretched for a prolonged period of time) that can lead to tingling and numbness in the fingers. I sleep in basically the “recovery” position except I try to keep the elbow under my head flexed to less than 90 degrees. I used wrist braces in the past at night to train my wrists to remain in neutral position. Haven’t found anything to do the same for my elbows!

    ronna wrote on July 2nd, 2010
    • I’m told wrapping your arm in a towel and securing it with rubber bands works fairly well.

      Lyle wrote on July 2nd, 2010
  5. What’s interesting is that when you look at all those side lying-ish positions is that their bodies are flexed at the hip, rather than having a deeply curved spine. When I look in on my 2 year old side sleeping that’s what he looks like, legs flexed up from the hip joint, spine relatively straight, not curled into a “fetal” position.

    Also, lying on the back is not ideal for pregnant women. There’s fancy science about compressing veins and all that, but ask any pregnant lady what’s comfortable (or at least semi-comfortable), and she’ll tell you she sleeps on her side. That is when she’s not getting up to pee.

    jj wrote on July 2nd, 2010
  6. i too had to wear wrist braces every night (although since going full primal 6 months ago not so often). But i switch hit between the recovery and the lookout position, and i see what you mean about the 90 degree angles…try using a small pillow, like a travel one, and brace it inside the arm under your pillow, that helps me with keeping the arm not so 90 degress :)

    amyj wrote on July 2nd, 2010
  7. I have been sleeping on the floor of my carpeted bedroom in the crossed armed recovery position and I have been sleeping like a baby.

    My only problem is that I seem much more sensitive to sound and light. The light maybe that I am much closer to the window and the sound maybe due to both ears being uncovered. Seems that this is both a blessing and a curse but it has been far more good than bad.

    Milton Hill wrote on July 2nd, 2010
  8. I sleep on my side just like the lady in the photo. I am on my back first for a few minutes to just think… then when its time to sleep I switch to my left side and sleep like baby every night. I bend my legs and keep my spine straight (I think). I never wake up with any pain unless I am sore from overdoing an exercise.

    Primal Toad wrote on July 2nd, 2010
  9. Great post! I’ll try some of these positions. I normally sleep spooned w/ my husband yet end up sleeping on my side w/ a leg up & the other straight out to the left side, my arm under the pillow & the other arm comfortably over the chest. Sometimes I wake up with the head off the pillow. I also sleep on my back. When I lived in PRico, I took naps in hammocks & its just the best way to unwind & rock yourself to dreamland :)

    Madeline wrote on July 2nd, 2010
  10. Some positions look awkward to the point a kinesiologist might even be concerned about it. I will have to try them out before I judging them though.

    JP

    Jean-Patrick wrote on July 2nd, 2010
  11. I tried out the lengthened spine trick at lunchtime lying on the carpeted floor of my bedroom. I have to say I was very dubious as I would normally sleep with earplugs and an eyeblind in a bed with covers and pillow etc!

    I normally settle in the classic recovery position on my left side. However, I duly lay on my back and let my arms fall onto the floor – elbows by my torso and lower arms around 90 degrees which flattened my shoulders to the floor nicely – and would you believe it I fell asleep, quite amazed, must try it out tonight and see what happens – another amazing Primal fix me thinks!

    Will it never end, Day 8 of no-poo and I just spent all day piling up all the ‘products’ in the house and throwing them in the bin!

    I’m sure sooner or later (and maybe he already has) Mark will post something spoof and millions of us will be trying it around the globe much to the amusement of the MDA worker bees!

    Kelda wrote on July 2nd, 2010
    • Yeah, I know what you mean. I also gave up ‘pooing’ and haven’t looked back. My mom and daughter said something about my hair looking nice and when I told them what I was doing, I got the unbelievable/mom’s at it again look. They can call me crazy, but Mark’s suggestions haven’t let me down yet. NO spoofing, please Mark.

      Karla wrote on July 2nd, 2010
    • Yea, like how Grok wasn’t monogamous!

      Dave, RN wrote on July 2nd, 2010
  12. Even though that shin position looks pretty uncomfortable, when my kids were babies I’d oftentimes find them sleeping in just that position, all bunched up on their shins with their heads against the corner fabric bumper of the crib. I read somewhere that they like that because it’s the same position they are in before birth: curled up with their head against the cervix.

    Dave, RN wrote on July 2nd, 2010
    • That explains a lot with how my toddler sleeps.

      Patsy wrote on July 2nd, 2010
  13. In light of your recent posts about sleeping, I was wondering if Grok would have been a light sleeper and if he snored. Or put another way, are industrialized humans more prone to heavy sleep and snoring? I would think a hunter/gatherer would need to be a light sleeper able to wake up at the slightest threat. I happen to be one and just had a terrible weekend of camping with snorers! Is there anything that suggests following a paleo lifestyle would lessen snoring?

    Steve wrote on July 2nd, 2010
    • Dunno, but I just spent 9 days sleeping in fields surrounded by snorers, best advice – get got ear plugs!

      Kelda wrote on July 2nd, 2010
      • good ear plugs!

        Kelda wrote on July 2nd, 2010
    • Yes! Read Weston Price – our modern nasal/mouth troubles are from our parents’ diets before we were conceived. Assuming they weren’t living in an isolated tribe somewhere, they likely ate the white sugar and white flour that cause “facial deformity,” as Dr. Price termed our modern orthodontic & nasal nightmares.

      MamaGrok wrote on July 17th, 2010
  14. “This guy is really all about protecting his junk.”???
    I don’t know about you, but my genitals are not “junk”.

    Rick W wrote on July 2nd, 2010
  15. I sleep in a hammock every night… my back problems are no more and I’m a peaceful, happy person in the morning.

    Shaleah wrote on July 2nd, 2010
  16. great points here; sleep posture is not something I think about but obviously makes a huge difference

    Katherine wrote on July 2nd, 2010
  17. I think honestly if diet is good and you get some activity in your life (nothing major) and you manage your stress well you WILL sleep well.

    Sleeping with good posture will only do one thing and thats help towards good body posture generally.

    Oliver wrote on July 2nd, 2010
  18. It was funny to see the shin pose; this is my toddler’s favorite position for sleeping. I thought he was strange, but maybe not.

    My favorite way to sleep is the recovery position. I have neck and back issues, and this position helps the most to ease pressure. Where I sleep is even more important — on a carpeted floor with a beanbag and pillow. My husband bought a $2,000 mattress for me, but when I try sleeping in it, I wake up in pain. Go figure!

    Patsy wrote on July 2nd, 2010
  19. I don’t find Tetley to be at all wacky. He draws on a rugged experience quite different than ours, and the sleeping positions may be truly primal.

    But the two Figure 2 pictures might be reversed (upper and lower), compared to the commentary. In the lower picture, the hip rotation moves the penis towards the ground (even more so during inevitable REM sleep erections); whereas, in the upper picture, protection really is afforded by the lower thigh, at least for the average length, or smaller, flaccid organ.

    The bunion remedy may be effective, but is probably not primal, as Grok, not wearing shoes, probably didn’t have bunions.

    Incidentally, Gokhale firmly disapproves of bare footedness for people who grew up wearing shoes.

    primalorgan wrote on July 2nd, 2010
  20. Lyocell sheets from Select Comfort are amazing! So comfortable! I just don’t want to leave the bed. Also they have an amazing body pillow that stays “plump” since there are seams sewn to prevent the fill from spreading or flattening. Love it!

    Medical professionals and massage therapists get 30% off.

    Phaedra wrote on July 2nd, 2010
  21. On side, sleeping mask on, pillow between legs (much more comfortable for the twig & berries) lengthen spine before settling. Works a treat for me everytime.

    Will wrote on July 2nd, 2010
  22. Haha… Primal Blueprint Law #11 – Protect your junk.

    Daniel wrote on July 2nd, 2010
  23. I usually sleep on my back. Once in a while, I will shift to the side for a while. No stomach sleeping though as it is mildly uncomfortable on the boobs. I will usually wake up only for unusual noises and lights, but not for commonly occuring ones. If after waking, I decide it was not important, I just go right back to sleep.

    I would guess this would have been a good survival adaptation, but then again, in a tribe, you could probably have had both light and heavy sleepers and both morning and night people. SOme might wake even before dawn and stir up the fires. Others might have wanted to stay up light and guard for half the night. It has often been said that natural people sleep when the sun sets, but seems to me, having people up late to guard and others up early to guard might have been a good method to protect the whole tribe. If you had a fire at night, and many people seem naturally drawn to nighttime fires, then you would probably not be going to bed right at dark.
    -Eva

    Eva wrote on July 2nd, 2010
  24. Hahaha, “genital-feeding insects”.

    I’m a new follower to the Primal Blueprint but find it so uncanny how, everytime I am thinking of something in my life and if I’m doing it right or not and if I need to make a change, you post a topic about it. I have been trying to work out my sleeping situation for the past couple of weeks and lo and behold, you talk it about. I love it. You’re a great man Mark, for all that you do for your fellow man and woman.

    My question is about night splints. For the past couple of years I have noticed severe crippling pain in my feet, off and on. Sometimes after a long day in shoes, (before I found the barefoot movement), but mostly in the morning right when I get out of bed. My feet kill me. I looked into everything, surgery, if I had a broken bone, if I had plantar fasciitis etc.. I heard that if I slept with these “night splints” on, it would keep my feet in a position that would keep me from relaxing the tendons and such and decrese the pain in the morning. Any thoughts?

    Jordan wrote on July 2nd, 2010
    • Paleo Diet author Loren Cordain points out that SAD often has less than half our needed magnesium level, while hunter-gatherers got something like 250%. Quite a few people I know have eliminated nighttime foot and leg pain spasms with judicious magnesium supplementation over a period of months using magnesium glycinate or magnesium taurate. In addition, others have found excellent relief using myofascial trigger point release. See the book by Clair Davies, The Trigger Point Therapy Workbook. But the trigger points involved may result from magnesium deficiency and may stop recurring after some months of supplementation.

      Andrew wrote on July 3rd, 2010
    • I take a couple of potassium capsules every night (99mg apiece) and my night-time leg and back spasms are a thing of the past. So you might try that, too, in addition to the magnesium.

      Griff wrote on July 4th, 2010
      • Valuable observation re potassium. Potassium capsule supplements are limited by law to 99 mg ea. capsule, which is only 3% of the RDA, in order to avoid side effects of concentrated potassium.

        Interestingly, increased intake of magnesium may itself help resolve low potassium (hypokalemia) problems, without additional potassium intake, though I’d expect a Paleo diet to be naturally very high in potassium.

        See, e.g.

        http://barttersite.org/magnesium-and-potassium-balance/

        So if I had symptoms of low potassium, I’d wonder about my magnesium level.

        Andrew wrote on July 4th, 2010
  25. Alcatraz prisoners “in the box” slept on their shins too.

    JD wrote on July 3rd, 2010
  26. For me it’s all about a large body pillow for comfy fetal side sleeping with a fan for white noise/cool breeze.

    Damndirtyape wrote on July 3rd, 2010
  27. can anybody please post a video of the lenghtening spine posture in correct form, same indicated by mark? I can’t figure it out. tnx

    jitsuka wrote on July 3rd, 2010
  28. I’ve experimented with different sleeping positions while recording my blood oxygen saturation all night using a medical pulse-oximeter. In my case, at least, sleeping on my back produces lots of desaturations – frequent episodes where blood oxygen drops indicating that my airway is being compromised by snoring. Stomach sleeping took getting used to, but produced the most consistent oxygen saturation all night long.

    Andrew wrote on July 3rd, 2010
  29. Somewhere around the age of 50 I acquired a frozen shoulder. Then the next year the other shoulder had the same thing.

    Ever since then, while sleeping on my side, the arm I am NOT sleeping on would go to sleep during the night and I would wake up with a numb hand and arm.

    However, I realized in the last week since going primal a year or so ago, that I no longer have that problem. Less inflamation? Could be.

    I apologize but penis eating bugs cracked me up. Yikes! Never heard of that. Luckily, it’s one problem I will never have to face.

    Sharon wrote on July 3rd, 2010
  30. Speaking of Paleo improving snoring. I’ve checked overnight oxygen saturation graphs after adopting the practice known as “oil pulling” (Google it). Overnight blood oxygen saturation improved. I suspect that the process improves airway muscle and tissue tone, perhaps by exercising the same the throat muscles that a hunter-gatherer would use often to suck hard-to-get marrow out of bones, etc.

    The dangerous medical condition often associated with snoring, obstructive sleep apnea, has been described as inconsistent with human evolution. Possibly something paleo tended to prevent it, like using head and neck musculature that we no longer use much or very hard.

    Andrew wrote on July 3rd, 2010
  31. I had experienced tremendous pain in my upper back shortly after I got married. I thought it was from weight lifting. I went to doctors, chiropractors, therapists, etc and nobody could figure out this pain or what was causing it. I couldn’t do any weight lifting for 15 years because it just made the pain worse. Two years ago I found a chiropractor who looked at my spine, my clavicles, neck angle, etc and she said, “You sleep on your side don’t you?” I said yes. She said, “Here’s what you do. Learn to sleep on your back, get a softer mattress with good support, loose the pillow, and ice your T2/T3 vertebrae three times a day for a month.

    Guess what? I followed her instructions and here I am two years later with absolutely no pain! What was happening is just what Mark described: Sleeping on my side was pulling my shoulder forward and bending my neck down for 6-8 hours a night. This was causing the insertions at the ribs and spine to become inflamed. All those years I thought the pain was the result of an old weight lifting injury when it was actually the mattress my wife and I had bought when we first got married that was too firm that caused the inflammation that brought on the weightlifting injuries!

    It took some getting used to but I can easily fall asleep now lying on my back with no pillow. And I’ll do it until my dying breath if that’s what it takes to keep my back and neck pain-free!

    Rick wrote on July 6th, 2010
  32. Is it just me or is this MDA post has more genital references than usual?

    I can only sleep in one position.
    On my stomach, both arms hugging the pillow and supporting my neck, one leg stretched out and one leg curled (and there must be a pillow under this leg!). I’m not sure if it’s a good sleeping position but I can’t sleep other ways and I’ve tried.
    This is dangerous territory since I’m also a proclaimed insomniac -if I don’t sleep this way I won’t sleep at all.

    NSWM wrote on July 7th, 2010
  33. Some may need to avoid sleeping on the stomach as it can cause sleep paralysis–scary when you wake up and can’t move your head without a major mental effort. Also, sleeping on the left side can aggravate heart arrhythmias.

    As for Tetley’s reverse recovery position, my experience is just opposite. The scrotal sac and frenulum underneath the glans penis are in constant and annoying contact with the bed sheets, and this is too uncomfortable to endure for very long—although the raised hip is an unusual position which somehow seems to release lower back tension, so I’m experimenting with short duration practice.

    primalsleep wrote on July 7th, 2010
  34. Sleeping posture is sooo important…when you stop and think about how much time we spend sleeping if we’re in the wrong position it can’t really affect your muscles, ligaments and spine.

    I wouldn’t recommend sleeping on your stomach though…in practice (I’m a chiropractor) those who sleep on their stomach almost always have more neck concerns and degenerative changes on their x-ray if they’ve been doing it a long time.

    Michael Gibson wrote on September 18th, 2010
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  36. Every one of the examples and discussions is about a male sleeping position – nothing for us ladies who might have large breasts (which make a lot of sleeping positions difficult/uncomfortable) or pregnant women. I found his article interesting…but he should have talked to women too! I must say I am glad to not have a penis that could be nibbled by critters though…

    Lahoma wrote on September 22nd, 2011
  37. It doesn’t matter what position you start out in. After you’re asleep your body will readjust all night long without your knowing anything about it.

    Elizabeth wrote on January 9th, 2012
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