Why Your Sleeping Position Can Be Causing All Your Issues

Why Your Sleeping Position Might Be Hurting You (And What to Do About It)
By [Ryan Mercier - Osteopathic Manual Practioner]

In my practice, one of the most overlooked contributors to chronic pain, postural dysfunction, and even systemic symptoms is the way people sleep. Think about it: you spend 6–8 hours (or more) in the same position every night. Multiply that over weeks, months, and years — that’s a lot of time in a static posture.

This is where Wolff’s Law comes in: the body adapts to the positions and forces we repeatedly subject it to. Sleeping positions are no exception. Over time, they can shape your structure — for better or worse. Often, I see these sleeping habits carry over into how people sit and even stand during the day. This can create a cycle of dysfunction that leads to injury, discomfort, or chronic symptoms.

Let’s break down some common sleeping positions and the problems I frequently see associated with each.

Disclaimer: go to previous blog to see how you should be sleeping and a process on how to get better at it

1. Stomach Sleeping: Neck Twister

Stomach sleeping is one of the most damaging positions for the spine. Most people who sleep this way turn their head to the same side night after night, putting excessive strain on the neck. Over time, this repetitive motion can damage the joints, reduce blood flow, and overstress soft tissues.

It’s not just the neck. Stomach sleepers often lie in a "Spiderman" pose — one leg bent up, one arm twisted — placing the spine and pelvis in a torsioned, unnatural position.

I often use the analogy of a plant: if you cut the root, everything above it begins to deteriorate. Your neck is the root to your brain — the control center of the body. Poor neck alignment can lead to a cascade of dysfunction.

Common symptoms in stomach sleepers:

• Neck pain or stiffness
• Radiating arm pain or numbness
• Headaches
• Anxiety
• Digestive issues
• Thoracic and lumbar tension
• Postural imbalances
• Sleeping issues

2. Side Sleeping: The Shoulder & Spine Grinder

Side sleeping is incredibly common — and problematic. The shoulder girdle is made almost entirely of soft tissue. Night after night, compressing it under your body weight creates microtrauma and misalignment. Over time, this leads to rounded shoulders, shoulder impingement, or chronic joint inflammation.

Add in the fact that most people curl into a fetal position on their side, and we start to see a pattern of spinal flexion. This repeated posture can cause a gradual kyphotic curve (hunchback) that shows up in how people sit, work, and move. Eventually, the head starts to drift forward, increasing strain on the neck and lower back.

Common symptoms in side sleepers:

• Shoulder pain or impingement (often confused with injuries from sports like pickleball)
• Hunched posture
• Mid-back tightness
• Lower back pain (caused by shifting the center of gravity forward)
• Neck strain and “Dowager’s hump”
• Vertigo, headaches, and even ENT symptoms
• Sciatic-like symptoms due to spinal rotation
• Reproductive health issues
• Digestive issues

A subtle but serious issue I see is torsion through the spine — like a corkscrew — as people often twist their torso and hips in opposite directions. This rotational stress can irritate nerves and lead to hip or leg pain.

Poor sleeping positions, especially stomach and side sleeping, can do more than just strain your neck and back — they can also impact your digestion, breathing, and even reproductive health. When you consistently sleep with your neck twisted or your body curled tightly into a ball, you compress the front of the body and place tension through the cervical spine where the vagus nerve — a key player in your parasympathetic nervous system — originates. This nerve acts like the fuse box for vital organs including the heart, lungs, digestive tract, and reproductive system. When it’s irritated or restricted, it can dysregulate these systems, leading to symptoms like bloating, reflux, pelvic discomfort, shallow breathing, anxiety, and fatigue.

Additionally, these compressed positions restrict the diaphragm’s ability to move properly, which not only affects oxygenation and energy levels, but also blood and lymph flow through the chest, abdomen, and pelvis. This can create a backup in circulation, reducing the efficiency of digestion and detoxification, while increasing systemic tension and inflammation. From an osteopathic perspective, structure governs function — and when your structure is chronically folded or twisted during sleep, your internal systems are under strain whether you realize it or not.

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A Functional Approach: Don’t Force, Adapt Gradually

Now — an important point: I never want anyone to force themselves into a new position that causes pain or leads to poor sleep. If you’ve slept a certain way for decades, change won’t happen overnight.

The goal is consistency, not perfection.

Start by setting up in the recommended position, then use a guided breathing sequence to ease into it. Over time, with the right treatment and postural work, the position becomes easier and more natural. Remember: if you can’t get into a certain sleeping position without discomfort, that’s a clue that your body needs treatment to release tension and restore alignment.

That said, there are exceptions. If someone in their 90s comes in with severe thoracic flexion (a major hunch) and can’t lie comfortably on their back — I’m not going to force it. But if you’re healthy and capable of adapting your sleeping position, the benefits are absolutely worth it.

Final Thoughts

Sleeping position is one of the most underappreciated influences on the body. You can do all the yoga, Pilates, and workouts you want — but if you're curling into the same dysfunctional shape every night, it's going to win.

Instead of chasing symptoms, look at the root. Align your sleep, and you align your structure, your movement, and your health.

Need help transitioning to a better sleep position or unsure where to start? Book a session with your local practitioners

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