💤We sleep for atleast 1/3rd of our life, and if we do it right, we would need to worry less about our health! So, let’s see one aspect of sleep today- Sleep position!
Sleeping over right side will enhance sleep quality and has been said to have reduced frequency of turning.(1)
Right>left>back
🛏️Another study suggests that the order of better sleep quality is as below(2):
Lateral> supine> prone
😴On overall sleep: Why supine is not good?
The study reveals that change in sleep preference from lateral to supine between nights, showed signs of a deep sleep‐inhibiting effect of the supine position.
All restlessness events including limb movements and arousals increase in supine position.(2)
🫁Respiratory health:
Respiratory health is preserved in lateral position than in the supine position, especially in people with sleep apnoea.(2)
Conclusions: Lateral position is better for general respiratory health.
🫀Cardiovascular health and sleep position:
Left lateral decubitus(LLD) position is associated with higher sympathetic activity due to lower cardiac output, increased pulmonary capillary edge pressure, gravitational distortion of pulmonary veins and/or compression of enlarged left ventricle against chest wall, so it’s better to avoid this sleep position in cardiac issues like heart failure.(3) In coronary artery disease with sleep apnoea syndrome (CAD with SAS) this position is beneficial. (4)
Conclusion: Avoid LLD in heart failure; may help in CAD with SAS
💪🏻Muscular, spine and bone health:
Supine position causes you to lose your lordotic curve, which is detrimental to spine health, which may present as low back pain in few, on contrary, Lateral lying helps maintain the natural lordosis.
Conclusion: Lateral sleep is more effective for reducing cervical spine, scapular and arm pain.(2)
🦠Sleep positional therapy on Gut health:
LLD position adapted while sleeping is known to reduce gastrointestinal content refluxes during night-time as oesophagus is relatively superior to stomach. This position reduces acid exposure time and acid clearance time. Head-end elevation improves the outcomes.(5)
Conclusion: LLD position is superior to right/ supine
🧠Brain and Sleep Position:
Lateral decubitus is healthier than supine as the latter correlates highly with patterns seen in patients having neurodegenerative disorders. Glymphatic system is more active and the clearance of cerebral tissue from waste productsis better carried out inright lateral decubitus(RLD) position due to the anatomical lateralization of the intracranial and extracranial drainage of veins.(6)
Conclusion: RLD position is superior toleft/ supine
Takeaways:
“As a whole, lateral decubitus is the best sleeping pill for a healthy person unless specified otherwise according to the underlying conditions.”
REFERENCES WITH LINK:
- Zhang Y, Xiao A, Zheng T, Xiao H, Huang R. The relationship between sleeping position and sleep quality: A flexible sensor-based study. Sensors. 2022 Jan;22(16):6220.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9416198/
- Rayward L, Ho SW, Green D, Little JP. Sleep disruption and sleep position: Increased wake frequency in supine predicts lateral position preference. Journal of Sleep Research. 2025 Feb;34(1):e14325.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11744251/
- Leung RS, Bowman ME, Parker JD, Newton GE, Bradley TD. Avoidance of the left lateral decubitus position during sleep in patients with heart failure: relationship to cardiac size and function. Journal of the American College of Cardiology. 2003 Jan 15;41(2):227-30.
https://www.jacc.org/doi/10.1016/S0735-1097%2802%2902717-1
- Urabe T, Takase B, Tomiyama Y, Maeda Y, Ishikawa Y, Hattori H, Uehata A, Ishihara M. Effect of Lateral Body Position on Heart Rate Variability in Patients with Sleep Apnea Syndrome. Journal of Arrhythmia. 2007 Jan 1;23(2):140-5.
https://www.sciencedirect.com/science/article/pii/S1880427607800251
- Simadibrata DM, Lesmana E, Amangku BR, Wardoyo MP, Simadibrata M. Left lateral decubitus sleeping position is associated with improved gastroesophageal reflux disease symptoms: A systematic review and meta-analysis. World Journal of Clinical Cases. 2023 Oct 26;11(30):7329.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10643078/
- Simka M, Czaja J, Kowalczyk D. Collapsibility of the internal jugular veins in the lateral decubitus body position: A potential protective role of the cerebral venous outflow against neurodegeneration. Medical hypotheses. 2019 Dec 1;133:109397.
Written by Dr Shobhitha Tantry B