Woman sleeping on stomach

Why Stomach Sleeping Isn't Bad for Your Neck

Do you avoid stomach sleeping to protect your neck?

It's understandable if you do because it makes perfect sense. Lying on your stomach with your neck twisted to one side for too long can eventually make it sore. It seems a no-brainer.

So this may sound strange coming from a Physiotherapist, but why?

If we consider stomach sleeping an expression of full neck rotation, why are we so adamant it's a problem? As an involuntary position, perhaps there's more to the story here.

So I'll put this to you guys:

Does stomach sleeping create a neck problem, or does it just expose an already problematic area?

Let's discuss this further.


Is Stomach Sleeping Bad For Your Neck?

As mentioned above, we don't like the idea of leaving our neck twisted to one side all night.

Breathing with your face buried into a pillow is difficult so it's hard to keep your neck aligned if you want to sleep on your stomach.

This idea is heavily reinforced by the hoards of us who wake up sore in the morning. We generally don't go to sleep with any discomfort so it's easy to blame sleeping positions if things turn ugly the next day.

Stomach sleeping is also associated with a "dead arm" or one that's "fallen asleep" during the night itself. It's not uncommon to wake up on our stomachs and feel like we've lost sensation to an arm or hand.

Usually, a change of position will breathe life back into the area.

There is also a lot of information about sleeping on your stomach while pregnant, but it's a little outside the scope of this article.

Most issues with stomach sleeping while pregnant rightfully focus on the trunk itself and less about the neck, and because this is a deep topic we'll just keep this specific to the neck.


Is Lying On Your Stomach The Real Issue?

To question this idea is to question years of long-held beliefs about our sleeping habits. As I mentioned above it seems a simple enough idea.

But what if it isn't?

What if it seems like stomach sleeping is bad for your neck, but in fact, it's just a trigger and not the cause?

To explain this further, it's important to provide some context.

We currently live in an age where we connect the dots that are most immediate to us.

If you lift an object and hurt your back it seems obvious the lift is at fault. If you wake with an ache you didn't have the day before, it's easy to assume something happened overnight.

But in actual fact, we just lack the necessary perspective to see things for what they are. It's hard for us to see that most issues aren't the start of something new, but the last straw.

If you suddenly hurt your back lifting (or coughing, sneezing, moving the "wrong" way, etc.) it's highly unlikely your back was normal beforehand.

It's more likely to be the 1,000th cut, not the first.

Again, it's almost impossible to pick up on this unless you're looking for it at the time.

I've previously covered why waking up sore in the morning doesn't have as much to with sleeping as we think. But to cut a long story short it seems our postures and positions the day before may be more important to focus on.

If you spend your waking hours in less than stellar spinal shapes you may wake with the consequences the next day.

In the article above I make the comparison to DOMS (delayed onset of muscle soreness). The idea of waking up sore from a heavy workout the day before sits well with us. It makes sense because there was a genuinely obvious occasion to help connect the dots. But often there isn't when dealing with other aches and pains.

And this is why stomach sleeping may not be as bad for your neck as we think it is.

Instead, it's more likely to expose the consequences of poor postural habits from the day before.


Anatomy of Sleeping On Your Stomach

Anatomically, our neck is designed to rotate.

Clinically, a “normal” amount of neck rotation is around 90 degrees either side. Anything less than that indicates restricted neck tissue - whether it’s painful or not.

When you gently take a neck to its full functional range of motion, you should feel a relatively smooth end "feel". When taken to the extreme our neck joints shouldn't jam up or come to a stiff end. Much like fully bending your finger back or fully straightening your elbow, there should still be a certain amount of "give" in the tissue. It's the same with the neck.

It's important to understand that resting at full rotation shouldn't be the vicious assault on our spinal tissue we think it is.

But this is the key. Far too many of us lack the full rotational capacity of the neck.

Thanks to this modern world of ours, most of us have accrued a whole bunch of hidden stiffness and tightness - particularly at the neck. Our lack of attention to good postural habits has a lot to answer for.

If you take a stiff neck to full range you are likely to meet a more rigid end feel. One that doesn't allow the nerves and surrounding tissues to exist happily. A "dead arm" is more a consequence of jamming up dysfunctional tissue than healthy tissue.

So let's reframe this question once again.

Is your neck sore because it’s in perfect working order and you’ve just forced it into a relatively normal end-range position one night?


Is your neck sore because it was already overloaded before going to bed and you’ve challenged it further by forcing it into an already compromised end-range position?

I'm sure you know where I'm going with this because clinically it seems to be the latter.


Tummy Sleeping Should Feel Fine... Eventually

At this point, it's not as easy as saying you should just go ahead and sleep on your stomach and you'll be fine.

In an ideal world, absolutely, but clearly we don't live in an ideal world.

As long as we continue to fill our days with iPhones, computers, desks, couches, and Fortnite, stomach sleeping may forever find the weak spots. But if we can improve on the health of our neck and the positions that compromise it, we should eventually be able to sleep on our stomachs and not suffer the consequences.

Clinically, we can make stomach sleeping more comfortable by freeing up that restricted neck tissue. We can support this by encouraging consistent improvements in postures and positions. By doing so, we can expect the negative symptoms associated with sleeping on our stomachs to regress. The proof is in the metaphorical pudding.

Either way, we should look at stomach sleeping as an expression of the range of motion.


Frequently Asked Questions

Is stomach sleeping bad for your neck?

For many, sleeping on your stomach can create neck pain and dysfunction. But it should be known that in a perfect world it shouldn't. Poor daily neck shapes and postures can gradually overload your neck leaving it vulnerable to the kinds of end-range shapes created by sleeping on your stomach. The idea here is by improving the basic shapes and postures you put your neck in during the day, you should feel as though your tolerance to stomach sleeping improves over time. After all, you should have more than enough slack in your neck tissue, to fully rotate your neck to one side, and keep it there without experiencing genuine discomfort.

What is the best pillow for sleeping on your stomach?

The best pillow for sleeping on your stomach is a flatter pillow. If a pillow if too thick it will force a neck that's already fully rotated into more extension. This may increase the likelihood of you jamming up those neck joints and irritating surrounding tissue.

What is the best position for sleeping?

The best position for sleeping is the one you feel most comfortable in. Don't manufacture a fancy shape if it feels unnatural and awkward. If you feel some shapes make you feel sore and uncomfortable in the morning take the time to appreciate your shapes and positions during the day. Improve these shapes and you should find many of those aches and pains regress over time, giving you a broader range of shapes to choose from at night.

How to prevent yourself from sleeping on your stomach?

You can avoid sleeping on your stomach with the help of additional pillows. Place them next to you to make it harder to roll over on to your stomach.

What situations during the day might set my neck up to be sore in the morning?

When looking to figure out why your neck may hurt in the morning, it's important to start with positions you spend the most time in throughout the day before. For many, this often looks like using a computer, laptop or phone at work, on the couch or in bed. For others it may be looking down at work, playing an instrument or doing chores. Once you can recognize the shapes putting you most at risk it then becomes much easier to improve them, increasing the likelihood you wake pain and dysfunction-free.



With this in mind, I ask that you re-consider whether stomach sleeping is bad for your neck.

Instead, put some thought into the positions you put your neck into during the day. We’re talking looking down at work or at home, laptop use, reclining and watching TV through your feet, etc. Anything that leaves you with a hinge in your neck.

If you can, and are able to successfully improve your segmental neck mobility you may find sleeping on your stomach increasingly more comfortable.

How do you feel about stomach sleeping?

Let me know in the comments below!


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