Doctor, How Should I Sleep?
I am frequently asked questions about sleeping: positions, types and brands of mattresses and beds as well as my opinion of pillows. I thought today I would discuss my standard answers.
Sleeping Positions: For years I have wondered how this popular notion that the "fetal position" was good for you. I want to dispel that myth here and now. The fetal position is only good for fetuses. Once the human skeleton has developed its lordotic and kyphotic curves, after we begin to walk, nightly maintenance of these normal spinal shapes is critical to spinal hygiene and rest. Your lower spine is always more vulnerable in a flexed position. Bending at the waist is the position in which injuries most likely will happen, i.e. sneezing, lifting, slouching in a chair, stooping over a bench or bed, et cetera. Blows and traumas in the seated position, with a flexed lumbar spine are common causes of vertebral and discal injuries.
At night it is much better, and more relaxing to sleep with your knees and hips only slightly flexed almost in the standing position, only lying down. The best sleeping posture is on your side, with a pillow between your knees, or on your back with a pillow under your knees. The fetal position causes a forward flexion to your lower back and renders it vulnerable to the rotational forces of having one leg raised more than the other, or to lateral bending forces of sleeping in a less than supportive bed.
Always attempt to have your pelvic bones parallel to your shoulders, thereby keeping your spine straight and not allowing it to sag into the mattress. This is one of the frequent causes of nighttime sore backs.
Beds: I generally don't like waterbeds. The supportive nature of water is such that these beds are OK for tired backs, but not for sore backs. If you have a sore lower spine, your muscles need to relax at night in order for healing to begin. If these muscles are required to maintain your vertebral column in a specific antalgic position against gravity in a waterbed, relaxation and therefore healing will not occur adequately. My experience is that people who buy waterbeds usually enjoy them for about 5 years. After 7, these beds are generally abandoned.
There are various foam rubber beds on the market today. My belief is that foam rubber does not have a good memory and subsequently never completely returns to its original symmetrical shape in the time it has before being deformed again by body weight. Perhaps if these beds were allowed 30-48 hours before being occupied, they would rebound completely. However, this is not practical given the 24-hour day. What tends to happen is, over time, the foam takes on the shape of your body position. This is great if you always lie in the exact same spot each night, but who does that? These same principles can be applied to foam pillows.
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