25 Aug 2011
By: LEA WEE
An ideal sleeping position is a comfortable one, which generally results when the body is aligned, experts say.
This is when the right and left sides of the body mirror each other and the spine keeps its gentle S-curve, said Ms Ngo Xueting, a senior physiotherapist from Tan Tock Seng Hospital.
People who tend to fall asleep in a misaligned position, such as at their desks, are more likely to wake up with neck aches, said Dr Ong Thun How, the director of the sleep disorders unit at Singapore General Hospital (SGH).
Some positions can cause nerve damage. If a person falls asleep with one arm draped over the top edge of a hard sofa, the pressure could damage the radial nerve on the underside of the arm. The condition, called radial neuropathy or “Saturday night palsy” because it tends to affect people who get drunk and fall asleep on chairs, causes numbness and pain in the hand. The nerve damage may be permanent in some cases.
Most people would naturally shift their sleeping positions through the night to achieve a comfortable posture, said Dr Ong.
Dr Ong and Dr Chua Ai Ping, a consultant from the division of respiratory and critical care medicine at National University Hospital, recommend these sleeping positions for people with different problems:
SLEEPING ON ONE’S SIDE
• People with sleep-related breathing problems
Sleeping on the back has been shown in studies to be harmful to those who have obstructive sleep apnoea, in which the airway is blocked during sleep. This is especially so in patients with positional-related sleep apnoea, in which sleeping on the back makes it more likely for the tongue and surrounding muscles and tissues to fall back and block the airway. To prevent this from happening, people with sleep apnoea are encouraged to sleep on their sides.
• Snorers
Most people who snore will find that they snore less if they lie on their sides. If they have a deviated nasal bone where one nostril is bigger than the other, they should lie on the side that the smaller nostril is on. To find out which nostril is bigger, breathe in through one nostril while closing the other − the bigger nostril is the one which is easier for you to breathe through.
• Obese people
They may find sleeping on their backs uncomfortable as the stomach would push against the diaphragm, a major breathing muscle. This makes it difficult for the lungs to expand.
• Pregnant women
Pregnant women, especially those entering their sixth month of pregnancy, should avoid sleeping on their backs as this may cause the heavy uterus to press on major blood vessels and impede blood circulation. One major blood vessel which could be affected is the inferior vena cava, which lies to the right of the body and returns blood to the heart. The heart may be unable to pump effectively and this could lead to a drop in the blood pressure. So pregnant women should sleep on their left sides.
PROPPED UP
• People with heart failure or stomach acid reflux
Patients with heart failure may feel breathless lying flat and may be more comfortable sleeping on two to three pillows. Those with heartburn or other abdominal symptoms because of stomach acid reflux can reduce the risk of stomach acid going up into the oesophagus when they are propped up.
CHANGING POSITION OFTEN
• Stroke patients
Placing the body in one position for too long may result in pressure sores. Stroke patients who have difficulty moving themselves should have someone to help them change their body positions every one or two hours.
DOS AND DON’TS
Most people will toss and turn during sleep to find a comfortable position for themselves. To reduce the chances of this happening, you can take simple steps to make your preferred sleeping position more comfortable, said Ms Ngo Xueting, a senior physiotherapist at Tan Tock Seng Hospital.
First of all, you need a pillow and mattress which support the natural alignment of the body. This means that when you lie on your back, an imaginary horizontal line running through the ear is parallel to one running through the rest of the body. When you lie on your side, the horizontal line running through your nose should be in line with the rest of the body.
Once you have a good pillow and mattress, here are additional tips to sleep better, said Ms Ngo.
1. SLEEPING ON THE BACK
Get someone to check that your body is aligned. The hands can be placed comfortably on the stomach (top) or by the sides of the body. If this position causes slight discomfort, it could mean that the lower back is too arched and tensed. Placing a pillow under the knees (bottom) can help flatten the arch and reduce tension in the lower back.
2. SLEEPING ON THE STOMACH
This is generally not recommended because the person would have to twist his head to the left or right. This disturbs the alignment of the spine and may cause neck pain. However, if the person finds this position to be the most comfortable, he should make sure the pillow is not so high that the neck is hyper-extended (over-stretched) and the lower back is over-arched. To be more comfortable, he can raise his arms and rest his head on them.
3. SLEEPING ON THE SIDE
Even when sleeping on the side, it is important to keep the right and left sides of the body as symmetrical as possible.
Crossing the left upper leg over the right lower one, for instance, is not encouraged as it would cause the left upper knee to drop and the left hip to be rolled forward. This twists the lower spine and may lead to lower back ache.
Instead, keep the legs bent at the knee, one on top of the other, so that the lower leg can support the upper one (top).
It may also help to put a pillow in between the bent knees for greater support (centre). Or hug a bolster to support the upper arm and leg. Those with large hips may also find that when they lie on their sides, there is a space between the waist and the bed. This can cause the upper body to sag downwards and strain the lower back. To prevent this, put a rolled towel into the space (bottom).
Email: leawee@sph.com.sg
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