Spine Alignment and Sleep

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There are many factors to consider when you’re aiming for great quality of sleep. And one of the biggest things between you and a good night’s sleep is your sleep posture or spine alignment.

We’re diving into the importance of proper spine alignment during sleep, as well as the best spine alignment for different sleep positions.

What is Spine Alignment and Why Is It Important?

The word “posture” may make you think about is your standing or sitting posture. However, there’s another important type of posture — your sleeping posture.

If you’ve ever woken up and, instead of feeling well-rested, you feel like someone used your back as a trampoline, the culprit is most likely a bad sleeping position.

Spine alignment is directly tied to your sleep posture. The average person spends one-third of their life asleep, so having a poor spine alignment while you’re sleeping can have a big impact.

How can you achieve good spine alignment? Experts say that you should always aim for positions that will give you a neutral spine alignment. A neutral position follows the natural curves of the spine, which minimizes the pressure and strain on your spine.

How to Get the Best Spine Alignment For Each Sleep Position

Some people fall asleep better on their backs, while some prefer to sleep on their sides. Luckily, there are ways to achieve a neutral spine alignment, depending on your preferred sleeping position. Here’s how:

Best Spine Alignment For Back Sleepers

This is the best sleeping position for a neutral spine alignment because there’s minimal pressure on your back, and the weight is evenly distributed across your body. Here’s how to do it:

  1. Lie flat on your back and relax. 
  2. Align your head, neck, and spine. 
  3. Place a pillow under your knees for support. This helps keep tension and strain off your lower back. 
  4. Add a small pillow underneath the small of your neck to relieve pressure from your neck.

Best Spine Alignment For Side Sleepers

If sleeping on your back is uncomfortable, the next best position is sleeping on your side:

  1. Place a pillow to elevate your head and neck so that it stays aligned to your spinal column. 
  2. Elongate your legs so that your spine stays in a neutral position.
  3. Add a firm pillow between your knees to prevent your pelvis from tilting out of alignment.
  4. You can also add a small pillow to fill in the gap between your waist and mattress. This will help maintain the natural curves in your spine.

Best Spine Alignment For Stomach Sleepers

This sleeping position can add more stress to your spine, neck, and joints, but there are ways to make it work for you:

  1. Put a pillow underneath you, just between your pelvis and lower abdomen area. This will give your back support and alleviate some of the pressure.
  2. Use a firm and flat pillow for your head to support your neck. Depending on your position, however, you can opt to sleep without one.

Keeping your neck turned for a long time puts a lot of strain on your neck and head, which can lead to soreness in the morning. As much as possible, try to keep your head and neck aligned with your spine.

Best Spine Alignment For Combination Sleepers

Maybe you’re the type of person who likes to change positions when you sleep. Whatever position you choose, always remember to keep your head, shoulders, legs, and back aligned.

Use a combination of pillows of various sizes and firmness levels to find the right support for your body.

Tips to sleep better

In addition to your spine alignment, here are a few other things you can consider to improve sleep quality.

  • Choose the right pillow for you. Depending on your preferred position, make sure that the pillow you choose is comfortable and provides the support you need. Take note of the firmness level, size, and material of your pillow. Check if your pillow is placed too high or too low, as it can cause hyperflexion, which strains the neck.
  • Find a comfortable mattress. A mattress is a worthy investment. Similar to your pillows, make sure that the mattress you choose is comfy and supports a neutral spine position. Firm mattresses are generally good for back sleepers and stomach sleepers. Side sleepers get extra support and cushion from softer mattresses.
  • Exercise regularly and properly. Proper exercise can keep your mind and body — specifically your spine — healthy. Just make sure you’re following proper posture to avoid straining your back.

When to Speak With a Doctor

Back pain can be caused by multiple things. But if you’re constantly experiencing back pain or you feel like it’s getting worse, you may have issues with your spine and back.

If you’re experiencing the following symptoms, it’s time to seek medical help:

  • Sudden or frequent fevers accompanying back pain
  • Numbness in certain body parts, like your legs, back, or groin
  • Difficulty in urinating
  • Loss of bladder or bowel control
  • Sudden and unintended weight loss
  • Chronic back pain after trauma


Keeping your spine aligned while you’re sleeping can do wonders for your spine health, sleep quality, and overall health. No matter what sleeping position you’re most comfortable with, you should always keep in mind the proper sleep posture.

Aside from your spine alignment, choosing the right pillow and mattress can also have a great effect on how restful your sleep will be.

If you’re experiencing constant back pain, consider seeking medical help. This may be a sign of an underlying spine or back issue.

Source List

Aminoff MJ, et al. (2011). We spend about one-third of our life either sleeping or attempting to do so. https://pubmed.ncbi.nlm.nih.gov/21056174/

Back pain. (n.d.) https://www.nhs.uk/conditions/back-pain/

Kim D, et al. (2021). Spine Sagittal Balance. https://www.ncbi.nlm.nih.gov/books/NBK534858/

Williams, RS. (2017). How Sleep Position Affects Your Spine. https://www.coastalorthoteam.com/blog/how-sleep-position-affects-your-spine

Yu, E. (2018). What sleep positions are best for your back? https://wexnermedical.osu.edu/blog/what-sleep-positions-are-best-for-your-back