"Sleep-onset insomnia" occurs when people have difficulty falling asleep, even when they are tired. "Sleep maintenance insomnia" refers to difficulty staying asleep during the night. " is a hybrid condition characterized by sleep-onset and sleep maintenance insomnia symptoms. There are many reasons why people have trouble falling asleep and staying asleep, and there are equally as many treatment approaches to try to help resolve these different issues. This article could be a BOOK if we went into all of that! Instead, we'll focus on how to position your body and best support yourself to optimize your ability to fall and stay asleep comfortably.
My clients often ask "What is the best position for sleeping?" I believe the best answer to that is "Any way that YOU are comfortable!" That might not be the answer you were expecting. Truly, sleep positioning and comfort is such an individual thing. Some people can sleep flat on their backs, some prefer side-lying, while others prefer stomach sleeping, or even sleeping in a recliner chair. Unfortunately, body pains often get in the way of sleep tolerance no matter what your position. Overall, being in a position that YOU find comfortable and supportive is the best one for YOU!
To best align the spine and allow the body to fully rest and restore itself during our sleep, there are some recommendations based on positioning. It is best for our spine and muscles to sleep on our backs. If you are able to sleep on your back, it is ideal to place a small pillow under your head and neck, not your shoulders. In fact, if you are able to pull the corners of your pillow up over your shoulders, this provides even more support to the small curvature in the bones of the neck. Keeping your legs straight is ideal to rest the hip flexor muscles on the front of the pelvis and minimize tightness throughout the night. Some people can sleep on their back, but they need some type of bolster or pillow support placed under their knees to take pressure off of their back. Others have the fancy, adjustable beds that bend to provide an elevated head or allow the knees to be supported in a slight bent position or even with the feet elevated. These are all acceptable positions especially if you find them comfortable and can fall and stay asleep without issues.
For side sleepers, it is important to have support through your hips and legs to keep tensions minimal through the pelvis and spine, and it is helpful to have your head, shoulders and arms supported to minimize tension through the neck or prevent your arms from falling asleep. Personally, I am a side sleeper and I can't do it as well without my trusty "Body Pillow." Many of you have heard me sing the praises of this lovely, simple support for my body. This long pillow goes between your legs to keep your top leg supported, instead of having the weight of the the leg pulling down with gravity, which creates tension through the pelvis and lower spine. This pillow is long enough to support you between your lower legs and feet as well, which further supports the natural alignment of the legs, pelvis, and spine. The top of the pillow comes up to about chest height, allowing space for your face to breathe, and a nice place to rest your top arm and hand. As for your head, it is best to have a medium pillow to take pressure off of your bottom shoulder and support a neutral neck position. Propping your lower arm and hand on top of the pillow in front of your face is a better option than tucking the bottom arm underneath your head pillow, as this second position really pulls on the shoulder rotator cuff and stresses the nerves that run through the front of your shoulder. I usually alternate between resting my bottom arm on the head pillow and hugging the body pillow in front of me. (I'm getting sleepy just typing this...) If you are looking for a good body pillow, HERE's the one I recommend. There are so many fancier options available, but this simple one seems to do the trick for me.
For those of you who are stomach sleepers, don't worry...I'm not going to tell you NOT to do this. Many practitioners do caution people to avoid this position as it can create undue stress through the neck and upper back. As long as you don't use a huge pillow (in fact, opt for NO pillow at all) and you are comfortable, you might be okay. If you can try any of the other recommended positions instead, your spine might feel even better.
Another question often asked is "What type of pillow or mattress should I be using?" This is another very individual thing based on your body size, preferred sleep position, budget, etc. A firm mattress is best to support the spine and a small to medium pillow usually does the trick to support the head and neck. Personally, I sleep on a firmer memory foam mattress and love it, but I can't stand the memory foam pillows I've tried! I prefer a medium density, medium sized pillow since I am a side sleeper. Some of my clients love their Sleep Number beds as they can find their preferred comfort level and so can their significant other. A pillow topper can help to make a mattress that is too firm feel a little more comfortable, or a memory foam topper can do the same thing if your budget doesn't allow for a full memory foam mattress. Some clients have always slept with a feather pillow, while others are allergic or like more support. The right mattress and pillow is based on what feels best to the individual sleeper!
As simple as some of these suggestions seem, they can really help your body to have the support and comfort it needs to relax, restore, and allow for a better night of rejuvenating sleep. Let me know if you have any other positioning advice or what sleep comfort aides have worked best for you, as I am always open to learning more and having more suggestions to help others.