Research on Best Sleep Postures: Prone, Supine, Left or Right?
Warning. Most natural (and often medical) websites claim that the human body repairs itself during sleep.
However, dozens of medical studies, as well as clinical observations, testify that sick people are most likely to die
from 4 to 7 am due to heart attacks, strokes, seizures, exacerbations of asthma and COPD, and many other conditions
(see the summary of these studies here: Sleep Heavy Breathing Effect).
It is also true that over 90% of people have lowest body-oxygen levels during early morning hours. Therefore,
do not get fooled by those people who advise to sleep more and feel better about sleep. Your health will get worse and worse
if your body oxygen drops during sleep.
While most internet sources, including official medical websites,
recommend supine sleep as the best sleep position, medical evidence (26 published clinical studies)
revealed that supine sleep was the worst position for following conditions:
- Asthma (Ballard et al, 1991)
- Asthma and allergies
in wheezing children (Ponsonby et al, 2004)
- Asthma (nocturnal) (D'Alonzo & Ciccolella,
- Back pain in pregnancy (Fast & Hertz,
- Bruxism and swallowing (Miyawaki et
clenching episodes and gastroesophageal reflux (Miyawaki et al, 2004)
- Chronic respiratory
insufficiency patients (Ambrogio et al, 2009)
- Cough (nocturnal) and
coughing attacks (Bonnet et al, 1995)
- GERD (gastroesophageal
reflux disease) (Khoury et al, 1999; Wang et al, 1999)
- Geriatric inpatients (Hjalmarsen &
Heart failure patients with central sleep apnea/Cheyne-Stokes (irregular)
respiration (Joho et al, 2010; Szollosi et al, 2006*)
- Irregular or periodic breathing
(Hudgel et al, 1993)
- Pregnancy (Trakada et al, 2003)*
- Sleep apnea (Ingman et al, 2004; Yoshida, 2000;
Matsuzawa et al, 1995; Miura e tal, 1992; Kavey et al, 1985)
- Sleep paralysis
and terrifying hallucinations (Kompanje, 2008; Cheyne, 2002)
- Snoring, hypopneas and apneas
(Jan et al, 1994)
- Stroke patients with sleep
apnea (Brown et al, 1998)
- Stroke (elderly patients)
(Schubert & Horaud, 1994)
(pulmonary) treated by thoracoplasty (Brander et al, 1993)*
Criteria for best sleep position
What are the criteria for choosing
the best sleep position? Epidemiological studies found that early-morning hours have highest
mortality rates and chances of exacerbations in the sick and severely-sick
patients. (Sick people are most likely to die during sleep!) That relates to asthma, COPD, coronary spasms and cardiac arrest,
angina pectoris, stroke, cerebral ischemia and stroke, diabetes, seizures,
inflammatory conditions, inflammation in the amnesic patients, and morning
sickness (for references and quotes visit
Sleep Heavy Breathing Effect). Blood-gas abnormalities is the
most common clinical findings in the severely sick just before death (see
Breathing Pattern). Hence, sleep is a deadly poison for the severely-sick and critically-ill people.
Even in normal subjects, a variety of adverse effects
is normal, and most people can testify that mornings are the time of their health
misery. Blood gases (arterial CO2 and O2 saturation) depend on our automatic-breathing patterns. In several above studies the researchers measured blood-oxygen saturation.
These studies are marked
with the "*" sign above. It was found in all of them that the supine-sleeping position produced the
worst blood oxygenation in comparison with any other body posture (Fast & Hertz, 1992; Hjalmarsen & Hykkerud, 2008; Szollosi et al, 2006; Trakada et al, 2003; Brander et al, 1993).
Best-sleeping positions must be
chosen on the basis of the higher-body-oxygen content.
Hence, light slow inaudible and strictly-nasal diaphragmatic breathing is the
key criteria of good sleep and best sleeping positions. It is, indeed, easy to
confirm that, when we are in a state of better health, our breathing during
sleep is lighter and slower so that others cannot hear or see it. Breathing
of sick people, on the other hand is fast and loud due to elevated-minute ventilation
(overbreathing or deep breathing).
can easily observe this effect, if you regularly pay attention to breathing
of your spouse, children and/or relatives and friends during sleep. When
they are healthy, their breathing is quiet and relaxed. When they are sick,
you can easily hear them.
Which medical professionals care about best sleep positions?
Official mainstream medicine continues to
ignore the devastating effects of sleep on health. In my view, there is only one
medical therapy that addresses sleep and sleeping positions, as necessary
parameters to optimize. The name of the technique is the Buteyko-breathing method. Each Buteyko
student starts the day with the morning-CP test (measuring body-oxygen levels
immediately after waking up), while the morning CP remains
the main criteria of health for the Buteyko method. This is reflected in
Buteyko Table of Health Zones and in this Sleep Table:
||Often >10 hours
||Often very poor
||Often >9 hours
Over 150 Russian MDs suggests prone sleeping
In relation to best sleep positions, over 150 Soviet and Russian doctors, while
testing their patients, found that there is the following approximate relationship between sleeping
postures and the body-oxygen level:
Prone position: lying with the front or face downward. Supine
position: lying down with the face up.
Note that these approximate results do not reflect many other parameters
that influence breathing during sleep. For example, sleeping too long in the
same position generally leads to reduced-body oxygenation. More physical
exercise improves one's ability to sleep longer in the same position.
Sleeping on hard beds results in more movements and better body oxygenation,
provided that sleeping on one's back is avoided.
for sleep (as in an armchair or bus/plane seat) is the ideal-sleeping posture for breathing and body oxygenation (although many people find it tough to use for each night). Russian Buteyko doctors
have the same opinion (e.g., Chief Physician of the Moscow Buteyko Clinic Andrey Novozhilov, private communication). Honorable physician and
doctor-therapist of the Moscow Buteyko Clinic, Tatiana Alexandrovna Kulik, in
her book "Buteyko Method for All" (ISBN: 978-5-9731-0213-5; Moscow,
ASS-Centre; 2010, 124 pages, in Russian) also states that sitting is the
ideal posture for sleep.
Unfortunately, since modern people do not learn how to sleep sitting from early childhood, most
of them find it uncomfortable to use. However, it is very efficient for speedy
breathing normalization and can be applied in special circumstances provided
that the angle of body inclination remains high. Many of my students found amazing health benefits of sleeping sitting. (Some actually completely switched to sleeping sitting all the time!) However, there are 4 important ideas that are really useful in order to "survive" this position through the whole night for beginners. These 4 suggestions are hidden as your bonus content.
New ideas about ideal sleep postures
December 2015 update. It seems that there is one option that is more comfortable for sleep than using hard chairs (even with support for the neck and elbows). This position allows easier relaxation, and its details and images are provided below, together with the link how you can actually buy the device that allows you to use this sleep posture right away (less than 50 USD).
Most people should avoid
sleeping on your back and alternate to between 2 best- sleeping positions: sleeping on
your stomach (or chest) and the left side. Note that there are many
intermediate positions between chest and left or right side. Indeed, if you
prop one of your shoulders with a pillow, you can sleep half-way on your
chest and this position is also good for maintaining light and slow
breathing and good-body oxygenation.
Dr. KP Buteyko suggested that severely sick people should sleep on
their stomach or chest, "If patients lie down, then they must lie on their
tummy. This compresses the rib cage, abdominal muscles, and the walls of the
tummy, thus decreasing respiration." (Dr.
Buteyko's lecture at the Moscow State University, 1972)
Test the effects of supine and prone position
If you are uncertain about the suggested best sleep positions, you can
measure your CP (body-oxygen level) after sleeping in different
positions for 10 or more minutes. (Just keep an illuminated electronic clock
or ticking clock nearby for counting your CP at night. Then you do not need
to turn the light on.) If you find that your CP remains the same or even gets
higher after sleeping in certain positions, it is smart to use them for
improving your health and ignore these and any other statistical findings.
References (26 clinical studies that tested effects of various horizontal sleep positions): - Best Sleep Position Studies.
to Prevent Sleeping on One's back - Simple technique for people with low body-oxygen levels
- Press Release:
World's Leading Health Media Promotes Disinformation on Best Sleeping Positions (22 Sept 2010)
About Ideal Sleep Positions
- Good Sleep Hygiene - Detailed summary
of lifestyle factors for good sleep.
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