Stomach Sleeping May Lead to Neck and Back Pain

By Aubrey Bailey, PT, DPT, CHT 

 Medically reviewed by Smita Patel, DO

Sleeping on your stomach isn't inherently "bad," but it can have some adverse consequences. Lying on your stomach for prolonged periods can increase pressure on your back, neck, and shoulders. However, stomach sleeping can benefit people who snore or have difficulty breathing.

This article discusses stomach sleeping—risks, potential benefits, and how to change your sleeping position.

Risks of Stomach Sleeping

Most healthcare providers don't recommend stomach sleeping, especially if you suffer from neck or back pain.1

Sleeping on your stomach flattens out the natural curve of your spine and increases pressure on your lower back.2 In addition, it requires you to keep your head turned to the side, which can lead to a stiff or sore neck.

Sleeping with your face pressed against the bed—which can happen when sleeping on your stomach or your side—distorts the skin on your face, which can lead to the development of wrinkles.3

Stomach sleeping can also cause issues during pregnancy, particularly in the second and third trimesters when the belly expands more quickly.4 During this phase, sleeping on your stomach—or flat on your back—can put pressure on an important blood vessel in the abdomen and lower your blood pressure.

Healthcare professionals recommend that pregnant people sleep on their left side to improve blood flow to the uterus and the fetus.5

When Could Sleeping on Your Stomach Be Beneficial?

Sleeping on your stomach—called the prone position—isn't all bad. Sleeping in this position can reduce snoring.6

Lying prone can improve breathing for people with lung issues. Gravity helps bring the lungs into a position that makes it easier to inflate as you breathe. Sometimes, healthcare providers recommend prone positioning during respiratory illness to reduce the risk of a collapsed lung (pneumothorax)—a condition that occurs when air gets between your lungs and your chest wall.7

Tips for Sleeping on Your Stomach

If you don't have pain and you plan to continue sleeping on your stomach, there are things you can do to help keep your spine in better alignment and reduce your risk of developing pain:8

• Use a thin pillow under your head or no pillow at all

• Place a thin pillow under your pelvis

• Choose a mattress with medium to firm pressure

• Perform stretches in bed before you get up

How to Retrain Yourself to Stop Stomach Sleeping

Most people do not spend the whole night sleeping in one position—and lying on your stomach is the least preferred sleeping position in the general population.9 However, if you are a stomach sleeper, you may wonder how to learn to sleep in a different position.

The ideal position for sleeping is one that supports the natural curves of your spine. This can be accomplished by lying on your back or your side. Use a pillow designed to support the curve in your neck.

If you lie on your back, place a pillow underneath your knees or between your knees if you choose to lie on your side.

Consider using a body pillow on each side of your body to help keep you on your back or side while you sleep.

Changing your sleeping position will take time. You might start on your back or side, then wake up to find that you have rolled back onto your stomach. With consistency, you'll become more comfortable with your new sleeping habits.

Tips for Improving Sleep

In addition to finding a comfortable sleeping position, there are other things you can do to improve your chances of getting a good night's sleep.10

• Avoid electronics one hour before bed

• Establish a bedtime relaxation ritual

• Keep the room cool (between 60 to 68 degrees)

• Keep the room dark

• Limit caffeine intake in the afternoon/evening

• Sleep for at least seven hours

• Wake up at the same time every day

Summary

Sleeping on your stomach isn't always bad, but it has the most potential adverse side effects of any sleep position. Stomach sleeping increases pressure on the spine and keeps the neck in a rotated position. It can contribute to developing wrinkles and pose blood flow issues for pregnant people. If you're a stomach sleeper, you can train yourself to sleep in a different position with patience and plenty of pillows for support.

Sources

Keck Medicine of USC. The best—and worst—sleep positions for back pain.

Cary D, Jacques A, Briffa K. Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: a cross sectional study. PLOS ONE. 2021;16(11):e0260582. doi:10.1371/journal.pone.0260582

Anson G, Kane MAC, Lambros V. Sleep wrinkles: facial aging and facial distortion during sleep. Aesthet Surg J. 2016;36(8):931-940. doi:10.1093/asj/sjw074

The Ohio State University. Should you sleep on your back while pregnant?.

National Library of Medicine. Problems sleeping during pregnancy.

Johns Hopkinds Medicine. Choosing the best sleep position.

Mount Nittany Health. COVID-19, lying in a prone position (proning).

Sleep Foundation. Sleeping on your stomach—is it bad for you?.

Skarpsno ES, Mork PJ, Nilsen TIL, Holtermann A. Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nat Sci Sleep. 2017;9:267-275. doi:10.2147%2FNSS.S145777

Sleep Foundation. 20 tips for how to sleep better.

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public.