Stomach Sleeping -- Perhaps Your Back’s Worst Nightmare!
Many patients and healing clients have come to me over the years with various physical complaints. Most of them were surprised to hear that certain habits, common to many of us, may not only be contributing to their problems, but would surely prevent any benefits being derived from any and all treatment they attempted!
For people who have complaints of fatigue, headaches, neck stiffness, shoulder problems, dizziness, tingling or numbness in the arms, asthma, thyroid issues, vision or hearing problems, or even recurring colds and sore throats, an essential but little-known first step is to discontinue stomach sleeping!
“Pinched” (or irritated) nerves in the neck and upper back can lead to all of these symptoms!
Irritation of the spinal nerves in the neck and upper back
After my first decade in practice as a chiropractor, and seeing occasional patients who were suffering from the above symptoms and not at all responding to care as expected, I discovered that most often they had a common underlying problem. They were stomach sleepers -- for either all, or some portion of the night.
As soon as I became aware of a patient's inappropriate sleeping habits, and recommended side or back sleeping instead, their back and neck conditions showed signs of rapid improvement. The results were so markedly positive, I eventually wrote an additional question on the front of my intake medical history forms directly asking, "Do You Sleep on Your Stomach? [ ] Yes [ ] No".
In so doing, I could identify this problem on a patient's first visit. I began to tell people at the outset of carfe that if they continued to sleep on their stomach, even for as short a period as 5 minutes during the night, I probably would not be able to help them with their back and neck conditions. This conveyed the message pretty clearly on how important it was to begin efforts immediately to completely eliminate this habit.
It's amazing, but in 28 years of practice treating thousands of people, I've found only 3 patients who were not able to completely discontinue stomach sleeping! It appears that there is a part of our mind that remains aware at night – ever so subtly -- when we are turning in our sleep. Thus, we can teach ourselves new sleeping habits, even in later adulthood, and in my experience it has been quite possible to “teach old dogs new tricks".
Stomach sleeping may be defined as any position where, in part or as a whole, your chest and stomach are in contact with the bed, and your head is turned to the side. So many patients ask if the semi side-lying position with one leg up and one arm up at 90 degrees counts as stomach sleeping, and the answer is definitely "yes".
This is a common innocent looking -- but dangerous -- stomach sleeping position.
As a demonstration of how the stomach sleeping position is truly stressful, I often suggest to a patient during their 15-20 min. initial history taking interview, that if their stomach sleeping position is so comfortable, why not turn their chair a full 90 degrees sideways and conclude the rest of our interview with their head twisted facing me, fully turned towards their shoulder. Some of them try it for a moment, but after a short while we both laughingly agree that no one would never sit and talk to someone in the same kind of position their neck is when they sleep on their stomach! In other words, if we had a choice -- and we were not un-conscious -- we would prefer a position with much less twisting of the head and neck! If our neck is aggravated or stiffens in a few minutes while fully turned, imagine the effect of hours spent with our heads in such a position all night…
If we were awake, we wouldn't hold this position long. Perhaps for a moment, but definitely not for hours--which is what happens while stomach sleeping!
From an anatomical perspective, sleeping with a full neck turn, especially with slight backward pressure as we lay on our stomach, shuts down many of the vital nerves exiting our spine in the neck region. This probably is what contributes to a dulling of consciousness and the senses, and causes sleep to set in. But while sleep may come easier, the terrible truth is that this also causes spinal nerve pressure, which sets off cascades of abnormal signals, interfering with the brain's communication with vital parts of the body, such as the eyes and ears, the thyroid gland, organs in the throat and upper chest, and triggering muscle spasms in the shoulders, arms, and hands. Many people who wake up with stiff necks or who get recurring headaches or neck pain can relate to these effects. Recurring shoulder problems or numbness and tingling in the arms/hands are also very common. Even if you don't wake-up with any noticeable problems, your weakened neck ligaments, irritated nerves, muscles, and joints may become easy targets for the slightest provocation by activities later in the day. Also the cartilage lining the joints of the spine degenerates, and the bones become arthritic due to the long periods of stress and abnormal pressure from stomach sleeping.
I had an 18 year old boy with intractable chronic neck pain who had developed clear degenerative arthritis, due only to a history of stomach sleeping; he never had any past injuries to his neck nor had he suffered any accidents or sports related trauma. The picture below shows degeneration not usually seen until after age 50, which is similar to what was found in this young 18 year old’s neck.
In contrast, one of my oldest patients, at age 96, had neck x-rays which had no sign of degeneration whatsoever. His spine was in great shape and his x-rays resembled those of a person in his 20’s … Thus, it’s not necessarily our age — but how we take care of ourselves — which matters most! When people finally discontinued their stomach sleeping habits, it was very common in both my young and old patients, to see their symptoms immediately improving, and a very good response to chiropractic care.
In addition to nerve injury in the neck, another portion of the spine which is typically traumatized in stomach sleepers is the lower back. The middle portion of our back, which our rib cage is connected to (the thoracic spine) has vertebrae which are designed for turning. However in the lowest part of our back — near our hips — the vertebrae are designed primarily for forward and backward bending, and they turn very little. So when we sleep on our stomachs with our back twisted at night, the low back area ends up suffering the most damage, since its not designed for such turning. This leads to spasms, nerve irritation, and weakening of the lower back at a vital stress point. Statistics say that 80 % of people in the USA will develop significant lower back problems during their lifetimes. Such issues can arise earlier for active individuals, especially athletes who do sports such as golf, racquet sports, baseball, etc., which involve a lot of twsisting forces in the lower spine. The low back is also a very common area to develop disc degeneration and arthritis early in life. Unfortunately, injury to the lower back not only produces muscle and joint pain, but the nerves in this region supply the bladder, reproductive organs, lower digestive tract, and prostate. These organs can become targets of regular irritation. Constipation, having to get up frequently at night to urinate, bed-wetting in children, prostate problems, bladder issues, infections, etc., can be symptoms of such repeated nerve insult. These conditions may be partially or fully correctible through chiropractic care, changing our sleeping habits, and good nutritional and exercise regimes.
The best way to avoid the myriad of adverse consequences of stomach sleeping is to re-train ourselves now to sleep on our side and back.
Some people find that willpower and positive intention alone are sufficient to change the habit. Other people need props like building a pillow "wall" that alerts them when they are turning at night. Some others find taping a Ping-Pong ball or similar object to their nightshirt provides a needed reminder if they are turning onto their stomachs in their sleep.
So what is the ideal way to sleep on one's side and/or back?
Here are some postural hints to maximize your support and comfort... While side sleeping, it is good to use one pillow under your head that can be ‘puffed-up’ to keep your neck more level horizontally, and another pillow between your legs to take pressure off the hip and back muscles. While back sleeping, it is good to use one thin pillow under the head, which allows the head to sink down, avoiding any propped-up neck position. Additionally, another pillow can be placed under the knees, raising them slightly to take pressure off the lower back. With regard to pillow type, I recommend either a ‘down’ or ‘down alternative’ filling, allowing it to be flatter for back sleeping while also being more ‘puffy’ for side sleeping. I haven't personally found that the well-advertised contour cervical pillows have been very helpful for my patients. I don’t believe they truly re-shape the neck curvature, and they often appeared to aggravate certain neck conditions in some individuals. Thus, I am of the opinion that choosing the ‘most comfortable’ pillow, for both back and side sleeping, is the best way to go.
What are some suggestions with regard choosing a good mattress?
I suggest going to several stores to personally to try different mattresses. Find a dealer with a 90 day trial guarantee, because our in-store brief testing can’t actually compare with our true sleep experiences over time and after breaking-in the mattress. Choose one which is slightly on the firmer side, but with enough comfort and ‘give’ to conform well to our body’s side curvatures. We don’t want to force our spine to have to twist and bend to conform to a mattress. Instead, we want the mattress to conform more to our bodies — giving support to the normal curves of our spine, shoulders, and hips. If we wake up with a lot of stiffness, it is possibly the sign of a poorly performing mattress — one which is either too soft, and not giving enough support, or one which is too rigid, and forcing our spine into uncomfortable positions.
In summary, during the portion of our day in which we are largely unconscious, it is clear that a lot can happen due to the effects of poor posture, especially if we consider 1/3 of our lives could be spent in positions which may be aggravating our spine and nervous system. Ignorance is definitely not bliss, especially for the many patients I’ve treated who suffered the pain and effects wreaked by stomach sleeping -- not only interfering with their day-to-day activities, but also compromising their athletic performance. Stomach sleeping can clearly create long-term damage to the spine and nerves, speeding degeneration and arthritis, and daily aggravating organ systems in our body— producing some effects which may become irreversible. It's important to consider taking time now to develop proper side and back sleeping postures which can contribute substantially to our long-term health, vitality, and wellbeing.
Stopping stomach sleeping is a simple first step, and sometimes a relatively easy fix, for problems that might otherwise persist for years!
For more information, if you have been experiencing chronic neck and shoulder problems, please click here for an article entitled…
SUGGESTIONS THAT MIGHT JUST
SAVE YOUR NECK!
