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As a physiotherapist, one of the concerns clients talk to me about most often is the inability to get a good night’s sleep due to pain.

Sleep deprivation can be brutal. When you aren’t getting enough sleep, you can be left more prone to injury and/or illness, or with negative effects on your memory, concentration and mood.

Physical discomfort at bedtime can feel very intrusive, as you are no longer distracted by other activities. Pain is also often worsened by long periods of inactivity that occur overnight. But despite these truths, you may have more influence on your overnight comfort than you think.

In my opinion, body position is possibly the most important factor in optimizing nighttime comfort. Here are some general rules I typically follow that can provide a good starting point when trying to settle in for a better night’s sleep.


If at all possible, avoid sleeping on your stomach. It forces your neck into an extreme rotation to one side or the other and can also push your neck into a bit of extension or backward bend.

This position also places increased stress in the lower back. For those with stenosis or osteoarthritis in the spine, it can be a very pain-provoking position.


Lying on your back can be a great position for neck, shoulder, back, hip and knee comfort. For this position to be successful, it is important to have a pillow that can support your head and neck in a neutral position (not propped up or extending backwards). The mattress must also be firm enough that your body doesn’t sink down at the hips, causing pain in the lower back.

Unfortunately, tightness in the hip and chest muscles are common and can sometimes cause this position to be uncomfortable for the lower back and/or neck.


Sleeping on your side is, in my opinion, likely the most widely tolerated position for comfort. Ideally, you should have a pillow between your knees to preserve the alignment between your spine, hips and knees.

Many of my clients also find it is helpful to have a small pillow in front of their body to “rest” the top arm on when lying on their side. This reduces the pull through the shoulder, neck and upper back.


If you are consistently uncomfortable overnight or in the morning when you wake up, it is important to better understand what’s happening in your own body and pick the sleep position that is optimal for you.

The challenge is that individual injuries and medical conditions mean that what is best for one person isn’t necessarily appropriate for the next. I always recommend connecting with a physiotherapist for an assessment to determine which sleep position is likely best for you.

A good night’s sleep is definitely worth the effort to find your optimal sleep position.

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