What’s the Best Position to Sleep in? Do we even need a Pillow?

, , 100 Comments


Will the real Randy Gardner please stand up? In 1964, high school student Randy Gardner
successfully stayed awake for 11 days and 24 minutes, setting the world record for the
longest a human has gone without sleep. Over the several days awake, Gardner experienced
everything from mood changes, memory lapses, random hallucinations to temporarily losing
the ability to identify objects and recall words. But you don’t have to stay awake for multiple
days to experience detriments from sleep, as Neuroscientist Matthew Walker will tell
you. “I would like to start with testicles. Men who sleep 5 hours a night, have significantly
smaller testicles than those who sleep 7 or more.” In his book “Why we Sleep,” Walker explains
the ins and outs of just how bad too little sleep is not only for your reproductive, cardiovascular,
and immune health, but learning and cognition as well. Interestingly, lacking sleep even affects
you socially. -“…so we just published a study demonstrating
that sleep loss will trigger viral loneliness.” As Walker is explaining here in this interview
with Rhonda Patrick, this paper he authored demonstrated that people are much less comfortable
with people being close to them after they’ve been sleep deprived. They even put people in an MRI scanner and
found that the brain is lighting up in a way that makes you more suspicious of people and
less able to understand their intentions. Now, one of the things that was striking to
me that Matthew Walker said was that you cannot recover a sleep debt. You can’t just “catch up on sleep” by
sleeping for 12 hours on a Saturday after 3 nights of sleeping poorly. So, if we only have one chance at sleep, then
sleep quality or the efficiency of sleep must be very important even if you’re getting
the recommended 8 hours a night. There are many things you can do to improve
sleep quality and I’ve discussed this in another video, but what I’ve been curious
about lately is sleeping posture. What is the best position to sleep in and,
what is the best kind of pillow? Or should we even use a pillow? This question has bugged me for a while because
I’ve tried all kinds of pillows including this thing that’s supposed to keep your
head from rolling to one side but I’ve never been 100% satisfied. “Oh, man. You want a bad night? Try sleeping on one of these.” The first thing I thought might be worth looking
at is how other primates sleep. A quick google image search of “sleeping
primates” – shows a lot of them sleeping on their side. As Charles Nunn explains, what the great apes
have in common with humans is that they all build some sort of comfortable nest or sleeping
platform each night. Humans have different bone structures from
apes of course, but I thought it would still be interesting to consider the position they
sleep in most often. This 2015 study, monitored the sleeping patterns
of 5 Orangutans for two years. They found that orangutans spent 3 times more
of their sleeping time on their sides than they did on their backs. Now While digging into human research, I had
trouble finding papers that specifically looked at how sleep position affected sleep quality. And, I couldn’t find any papers comparing
sleep quality when people used a pillow versus when they didn’t use a pillow. But we can of course use a bit of logic and
make some inferences based off the data that we do have. So I figure a sleep posture that promotes
good sleep quality would have to (1) Prevent snoring and (2) at least not impede the glymphatic
system. For now, let’s look at snoring. What’s happening during snoring is that
air flow is being partially blocked by tissues in the airway, as evidenced by a… snoring
sound. I think more often than not, people would
assume that snoring is mostly a nuisance to one’s sleeping partner and the effect on
sleep quality is not enough to cause alarm. However, A study from 2003 looking at 1,144
school children separated the kids into either “always,” “frequently,” “occasionally”
and “never” snoring. What they found was that in the kids, snoring
“always” was significantly associated with poor academic performance in mathematics,
science , and spelling. And snoring “frequently” was also significantly
associated with poor academic performance in mathematics and spelling . Another study from 2001 found that children
with lower academic performance in middle school are more likely to have snored during
early childhood. Another study from 1994 showed that between
age 4 and 7, “Daytime sleepiness, hyperactivity, and restless sleep were all significantly
more common in the habitual snorers than in those who never snored.” And Yet another study from 2005 titled “Snoring
predicts hyperactivity four years later” shows that “snoring and other symptoms of
sleep-disordered breathing are strong risk factors for future emergence or exacerbation
of hyperactive behavior.” I could go on with several more studies showing
children who snore secrete less growth hormone, how snoring is associated with headache and
daytime sleepiness as well as high blood pressure, heart attack and stroke but we can get into
the full details in another video. For now, Here’s two recent nights from just the other
week tracking my sleep with the app “snore lab.” Here’s a night where I snored a lot… and
slept about seven hours, and here’s a night where I slept less about 6 and a half hours
barely snored at all – most of what the app picked up was me rustling around and my air
conditioner turning on and off. As indicated by the orange frowny face, I
distinctly remember being very groggy this particular morning when I snored alot, but
quite refreshed this morning when I didn’t snore that much. One pretty clear example of snoring being
disruptive to sleep quality is the fact that it seems to wake me up – On the nights that
I do snore, the recording will show that the snoring sometimes wakes me up enough to rustle
around or change positions. This 2013 review on “positional therapy
in position-dependent snoring” explains that it’s often observed that snoring is
usually worse when sleeping on the back and better when sleeping on their side. And, several papers have shown that sleep
apnea gets worse when people sleep on their backs. During the American War of Independence and
later during World War I , soldiers were advised to wear their rucksacks on their backs while
sleeping to keep them on their side and avoid sleeping on their backs. This would prevent snoring and making their
position known to the enemy. Papers from 1984 and 1996 found that people
snore worse on their back, and this one 2003 study found that snorers snore less on
their side So far, it looks like sleeping on one’s
side or at least avoiding sleeping on your back would be good for sleep quality. This study from 1983 found that ”Consistently,
poor sleepers spent more time on their backs with their heads straight.” Now what about pillows? There are several types of pillows and most
of the ones advertised to improve sleep quality aim to support the neck. There is a natural curvature in the neck,
a lordosis, and you can lose that and develop something called flat neck syndrome. This is developed presumably from looking
down all the time, probably at your smart phone or using a pillow that is too high. But if we want to sleep on our sides, we shouldn’t
need to worry about having the perfectly shaped pillow and just get one that keeps your neck
from bending too much while you sleep on your side. Moving on, to further evaluate sleep positions
that promote good sleep quality, the position should be good for glymphatic transport. In the body, we have something called the
lymphatic system that helps with each organ’s problem of waste clearance – this network
of vessels extends through the body and collects cellular debris, proteins and other waste
from the spaces between the cells so it can be disposed of. The brain however, does not have lymphatic
vessels that it can use for waste clearance. As Neuroscientist Jeff Iliff explains in his
TED talk, this doesn’t make much sense considering the adult brain uses about 25% of the body’s
energy budget and generates a considerable amount of metabolic waste. “So how then does the brain solve its waste
clearance problem? The brain’s solution to the problem of waste
clearance, it was really unexpected, it was ingenious.” “So the brain has this large pool of clean,
clear fluid called cerebrospinal fluid. We call it the CSF.” The CSF fills the space that surrounds the
brain and wastes from inside their brain make their way out to the CSF which gets dumped
along with the waste into the blood.” In the brain, there is a specialized network
of plumbing that organizes and facilitates the cleanup process. You can see that in these videos… The frame on your left shows what’s happening
at the brain’s surface and the frame on your right shows what’s happening down below
the surface of the brain within the tissue itself. The blood vessels are labeled in red and the
cerebrospinal fluid that’s surrounding the brain in green. “…and as it flushed down into the brain
along the outsides of these vessels, it was actually helping to clear away, to clean the
waste from the spaces between the brain’s cells.” What’s interesting is that all this is happening
when you’re asleep – the video on the left shows how much of the cerebrospinal fluid
is moving through the brain of a mouse while its awake – barely anything. But when the animal goes to sleep, the CSF
rushes into the brain to rinse and clean it out. Alzheimer’s disease is an example of how
important this sleeping brain cleanup procedure is. A hallmark of Alzheimer’s disease is the
build up of a peptide called amyloid beta, and the glymphatic system helps clear this
stuff out of the brain. The research on sleeping position affecting
glymphatic transport is very limited, but this 2015 study had rodents sleep on either
their side, back or stomach and were monitored via magnetic resonance imaging. They found that “glymphatic transport was
most efficient in the lateral position” – on their side. Dr. Maiken Nedergaard said: “It is interesting
that the lateral sleep position is already the most popular in humans and most animals
— even in the wild — and it appears that we have adapted the lateral sleep position
to most efficiently clear our brain of the metabolic waste products that built up while
we are awake.” One interesting thing about this study is
that it specifically looked at clearance of the Alzheimer’s protein Amyloid beta and
found that removal of it was most efficient in the side sleeping position. Now This is just in rodents, but this study
was looking at how sleep position could affect neurodegenerative disease in humans. This study strapped a small device with an
accelerometer to the participant’s heads to monitor what sleeping positions they were
in and for how long. They found that those people spending more
than two hours sleeping on their back a night was significantly more frequent in those with
neurodegenerative disease. Those with neurodegenerative disease spent
nearly twice as much time on their backs while sleeping – controls spent around 30% of their
sleep on their backs, those with NDD spent around 50% of their sleep on their backs. The Hadza of Tanzania are often interesting
to look at as their lifestyle is thought to be similar to that of prehistoric humans. I couldn’t find studies specifically on
their sleeping position, but this brief video talking about a study on the Hadza’s sleep
patterns shows most of them sleeping …on their side. So, the data is limited but it’s enough
at least for me to want to try and sleep on my side more. However… the problem is that you can’t
just say “OK time to sleep on my side because Ulysses McGill said so.” “How’s my hair?” People unconsciously change their sleeping
position multiple times throughout the night. One study found that over the course of 1
night, subjects changes positions as many as 20 to 40 times per night. So how can we get ourselves to stay on our
sides, or at least bias ourselves to select that position more often as we rustle around
at night? In 1984, the journal CHEST published a letter
written by a patient’s wife. She had cured her husband’s snoring problem
by inserting a plastic ball into a pocket sewn on the back of a T-shirt to prevent her
husband from sleeping on his back. In fact, there’s a type of therapy called
“positional therapy” designed to keep patients off of their back – all kinds of
things from a backpack with a softball inside to a ball in a sock on the back to a shark
fin type thing to alarms that ring when you roll on your back. So … what if pillows are making sleeping
on our backs artificially too comfortable? That is, let’s say you lay down to sleep,
but you simply don’t use a pillow. Laying on your back might become a little
less comfortable now that your neck and head aren’t cradled in a cushy comfortable cushion. What’s going to be the more comfortable
position? Probably sleeping on your side because you
can support your neck with your shoulder or a pillow made out of your arm and hands. Surprisingly, there was one paper that addresses
this directly. In this paper by Michael Tetley titled “Instinctive
sleeping and resting postures: an anthropological and zoological approach to treatment of low
back and joint pain,” he argues that forest dwellers, nomads and tribal peoples suffer
from few muscoskeletal problems because they sleep in a “natural” posture without a
pillow at night. According to Tetley, he has “organised over
14 expeditions all over the world to meet native peoples and study their sleeping and
resting postures. They all adopted similar postures and exhibited
few musculoskeletal problems.” He says tribespeople often do not like having
their photographs taken so he demonstrates most of the postures himself. What was interesting about this paper is that
none of the positions he’s presented show people sleeping on their backs. So the data on this topic is limited, but
based on what I did find, so far it seems that the side position is the better position
for cleaning out your brain and preventing snoring from impeding your sleep, and ditching
the pillow might be the way to get yourself to spend more time in that side position. That’s the idea anyway. It’ll probably take some time to adjust
to sleeping without a pillow and I’m not saying this is realistic for everyone – if
you don’t snore, and you wake up feeling refreshed and are without back or neck pain
in the morning there’s probably no need to change your routine. Also maybe you could figure out some other
way to keep yourself on your side during the night without ditching your pillow. Actually I’ve been sleeping without a pillow
for about a week now and I can’t say I’m waking up drastically more refreshed, but
I haven’t woken up with a stiff neck or back yet – something that would usually happen
every other day. But I don’t really know if this way of sleeping
is keeping me on my side like I was thinking, so I’m planning to track a couple weeks
of sleeping like this with a wearable device and hopefully one of those baby monitor type
see in the dark cameras. I’m planning to post updates on my instagram
every now and then, and at the end of the experiment, I’ll post a thorough video on
youtube letting you know how it all went. And, If any of you would like to join me in
the sleep experiment, I’ll post in the description how I plan to do it. Also, if any of you have done a sleep tracking
experiment yourself in the past, please let me know in the comments or on instagram what
you used to track your sleep. This video was sponsored by Kenhub – which
is where most all the anatomical images used in this video came from. If you’re a medicine, nursing, or physiotherapy
student and want a way to drastically reduce the frustration involved with packing ridiculous
amounts of anatomy information into the thing between your two auditory ossicles, you should
definitely check out Kenhub. With hundreds of engaging videos, interactive
quizzes, complete articles and a full atlas with stunning images, Kenhub is the best tool
for learning anatomy I’ve come across and it actually makes the process fun. Check out Kenhub at kenhub.com

 

100 Responses

  1. What I've Learned

    July 31, 2019 2:21 am

    Hey everyone, still haven't officially started the sleep tracking experiment – particularly because I haven't found my Garmin (tucked away in a box somewhere – moved recently). Also looking for a good way to monitor sleeping position. Will update on my instagram – @jeverett.whativelearned

    Reply
  2. red warrior

    August 5, 2019 6:04 am

    Since a kid I was told sleeping on my back is the best position for my body.
    I got scammed… D:

    Reply
  3. Daniel Conifer

    August 5, 2019 7:21 am

    I'd take this with a pinch of salt as it was also found people that sleep less are generally more intelligent because they are more worried about things on life because of there thinking patterns.
    Also everyone sleeps differently. People I know who sleep 9 hours plus generally are not that intelligent.
    This is all theory.

    Reply
  4. Epicmonk117

    August 5, 2019 8:54 am

    If you’re sleeping in an area where you are at risk of being killed, sleep on your left side. This will make your heart a harder target.

    Reply
  5. S L

    August 5, 2019 9:08 am

    some months ago just thought.
    "why do we even sleep on mattresses and pillows if animals don't? If we never had mattresses or pillows we'll possibly adjust to a more primitive and natural way of sleeping?"
    So I've been sleeping on a very thin mattress on the floor for the past 7 months without a pillow.

    Some things I observed:

    I realised that because I didn't have any neck support I automatically went to my side and used my hands for neck support.

    I wake up feeling instantly awake and no morning sleepiness or fog.
    Lots of dreams.
    Breathing pattern changed.
    Neck feels a lot more upright.
    No more congestion in the morning.

    Reply
  6. Steve 30x

    August 5, 2019 9:08 am

    I use one of those neck support pillows which is not high like normal pillows. Its shallow across the middle where my head lies and has a long hump on each side where my nreck goes. I find using that pillow gives me great sleep. Some may argue that its only effective when you lie on your back but I have used the pillow with Yeats and do the majority of my sleeping on my side.

    Reply
  7. NothingTo DoCrew

    August 5, 2019 1:40 pm

    I sleep less then anyone i have ever met..Growing up i never slept in, in the marines we hardly ever slept, in college i used to not sleep at all on thursdays, and even now that im in my 30's i only get 7 hours of sleep in on the weekends. My Dad and brother are the same way and none of us fit any of the information above. Different bodies need different things i guess

    Reply
  8. Michael Jordan

    August 5, 2019 1:51 pm

    interesting thought on interspecies comparison:
    how do african americans sleep?
    the answer is surprising:
    on welfare-provided beds.

    Reply
  9. Αντωνόπουλος Γεώργιος

    August 5, 2019 4:26 pm

    I cannot remember having waken up from a nightmare and not been sleeping on my back. At least in my case there seems to be a certain correlation. I have developed such an anxiety for this position that whenever I gain some level of consciousness and find my self on my back I immediately force myself to change posture. Unfortunately this is also the posture in which I found myself, after waking up from the few amazing times I experienced lucid dreaming (mostly deliberate flying).

    Reply
  10. digitalXmage

    August 5, 2019 4:34 pm

    How about a video on veganism? Considering the evidence for environmental impact, health, ethics is pretty strong.

    Reply
  11. A Barracuda

    August 5, 2019 5:02 pm

    Pretty easy to sleep on my side bec of a TMJ disorder. Need to sleep on my left to relax my jaw. The pain really registers well in the subconscious.

    Reply
  12. HairGlitter JessiBlu

    August 5, 2019 5:58 pm

    What about my side face wrinkles.. Either I have a young brain, or a young face🤷‍♀️

    Reply
  13. DeusKDuo

    August 5, 2019 7:56 pm

    So i sleep like tribe when i have issues getting comfortable i end up throwing my pillow and sleep on my side with my top leg lifted toward the body.

    Reply
  14. Shadow Man

    August 5, 2019 8:26 pm

    I have several issues, with immunity. Will you be doing videos about the immune system, maybe stress diet and everything that can help or damage it (alcohol etc). I think this channel is the most informative there is and I would be very interested in hearing about this topic. Thanks!

    Reply
  15. Michael Powers

    August 5, 2019 8:45 pm

    Youtubes algorithms are so fucked up. Had to search your channel to see videos Ive missed when Ive loved your videos for ages.

    Reply
  16. LoveLife

    August 5, 2019 9:10 pm

    I learned last year in Anatomy and Physiology that research did find evidence of lymph stem in the brain.

    Reply
  17. Optic500

    August 5, 2019 9:22 pm

    Matthew walker failed to realize that everyones circadium rythym is different genetically and biologyically so what 9hrs works for some, others work on 3hrs

    Reply
  18. William Pickett

    August 5, 2019 10:05 pm

    I snore a lot and really loud but I do extremely well and I grew just fine considering I’m about average hight

    Reply
  19. Anhela Anhela

    August 5, 2019 10:16 pm

    i always sleep on my side/stomach, i can't fall asleep on my back and i wake up when i sleep on my back

    Reply
  20. hks f

    August 6, 2019 1:22 am

    Wow. Prophet mohammed pbh said that sleeping on your side is the best for you and your body. 1400 years before all of this tech and reaserch

    Reply
  21. Olivia Sellers

    August 6, 2019 2:08 am

    I actually don’t move at all when I sleep. But come to full consciousness to get into a new position. Tally about average of 5 to7 times per night.

    Reply
  22. kaebutt

    August 6, 2019 2:09 am

    I cant fall asleep unless I'm on my back. I always feel so uncomfortable on my side. When I wake up I usually am on my side though

    Reply
  23. Topaz Hooper

    August 6, 2019 2:16 am

    This is literally my life. I hate pillows and I always sleep on my side. Sleep has never been an issue for me because of this method of sleeping.

    Reply
  24. FortunePayback

    August 6, 2019 2:47 am

    Very interesting as someone who struggles with sleep constantly looking for a solution. I myself pretty much always have liked sleeping on my face. And if i'm on my side, I usually am using a super flat pillow on my arm. On my back…pillow goes on face.

    So i'm curious why I don't sleep that great then, because this is clearly no issue for me.

    Reply
  25. Kaden Clouse

    August 6, 2019 2:48 am

    I was thinking it might sound kinda dumb but what if while sleeping the body changes different positions to do different things that you’re body may need.

    Reply
  26. DABeardedHippy

    August 6, 2019 2:54 am

    should put something about snoring in the title as that is pretty much the first half of the video, or a time code after so people who don't snore know to skip it

    Reply
  27. Minmae

    August 6, 2019 3:05 am

    I used to exclusively sleep on my side as a kid because I would get nightmares if I slept on my back. It stopped as I got older and I started sleeping on my back after that because it bothered me when the pillow touched my face while I slept on my side. Now I realize I need to start sleeping on my side again

    Reply
  28. Good Hearts Get Torn Apart

    August 6, 2019 4:05 am

    I sleep on my stomach. One leg is straight and the other is bent outwards but closer to my side. I always look the way according to which leg is bent. Then I have one arm under my pillow and the other bent where the elbow is in between my bent leg and my stomach and my hand near my face. I also bend a little tiny bit towards the side but I’m sill on my stomach.

    Sometimes I sleep laying on my back and wake up on the floor.

    Reply
  29. Aaron Mijail Herrera Castro

    August 6, 2019 4:32 am

    One technique to adjust your sleep behaviour is having a child, when I slept with my kid I slept in one side and if I needed to move I was semi awake so notice how and where I move

    Reply
  30. artimiss1238

    August 6, 2019 4:42 am

    I get sleep paralysis while I sleep on my back so its always on the side or stomach for me!

    Reply
  31. fuckoff

    August 6, 2019 5:19 am

    Well I'm fucked I always sleep on my back and I've had sleep studys done I have a fucked up spine and hip and shoulders so that's why I cant sleep on my side

    Reply
  32. Fredrik Henriksson

    August 6, 2019 9:56 am

    I can only fall asleep on my back. I feel stable on my back, on my side it can even be painful

    Reply
  33. X4SOLE

    August 6, 2019 12:30 pm

    I'm a skinny guy who needs more comfortable bedding (2 winter quilt blankets and 2 soft mattress protectors), but I use a stiff pillow of about neck to shoulder height. I always sleep on my side and only snore if on back. I only sleep on back to power-nap after lunch for 20-40mins. In my experience, supine sleep may yet be more effective for power napping as it is not so hard to wake from a deeper sleep. I think I watched your other video about quality sleep so always keep in mind sleep cycles, circadian rhythm, etc. Great video though, thanks for clearing up some doubts about my sleep positioning.

    Reply
  34. Esoteric Emissary

    August 6, 2019 1:46 pm

    I can only ever sleep on my stomach or side. I never, I repeat NEVER fall asleep on my back. The only exception being that time I was in the hospital and given anaesthesia.

    Reply
  35. Esoteric Emissary

    August 6, 2019 1:56 pm

    Sleeping without a pillow? No, I like to have 3 pillows. One for the head, and a huge body pillow on both sides to wrap between my legs. Try doing that, and you will only ever sleep on either side.

    Reply
  36. Sudarshan Dahal

    August 6, 2019 2:34 pm

    I’ve tried to watch this video for the 3rd time now. And everytime I seem to fall asleeeriroppprroewusuwwperrh

    Reply
  37. Xandros999

    August 6, 2019 7:36 pm

    In the past I found that sleeping without a pillow would give me a hammering sleep inertia.

    Not saying this is true for for everyone. I'm special like that. Now I can only sleep with my head and torso supported or I'll start feeling foggy and groggy immediately. Special problems. Obviously this prevents me from properly sleeping the side.

    Reply
  38. Sonny Brown

    August 6, 2019 8:07 pm

    I end up with a lot of neck issues when I sleep on my stomach which is the position I end up on when I sleep on my side. I should note that I have something called overactive bladder. This is important to note as there is a link between an unhealthy bladder and brain disease such as Alzheimer’s. Bladder problems make you have to get up and pee at night or sleep through the urge which probably prohibits the proper sleep needed to flush the brain. I’ve yet to find a solution aside from not drinking fluids before sleep.

    Reply
  39. Lupe Bogi

    August 6, 2019 10:15 pm

    I ditched the bed for a second time last night (last time I slept for 10 days on the floor) and tonight I'm ditching the pillow too, so we'll see how it goes.

    Reply
  40. Tyler MacDonald

    August 7, 2019 12:49 am

    Hey! Can you please do a video on polyphasic sleep? It would be interesting since theoretically you may have more time and may be able to store memories quicker.

    Would this lifestyle be helpful for a university student?

    Reply
  41. Odiah Tyfany

    August 7, 2019 2:29 am

    I’ve done no research, but even I could tell u the best sleeping position is on your side

    Reply
  42. Faradelthia Twitch

    August 7, 2019 3:26 am

    HaHA! And people said i was weird for not using a pillow. I hate using pillows. Have to have nothin under my head or i cant fall asleep

    Reply
  43. General 666

    August 7, 2019 3:53 am

    I stopped sleeping with pillows months ago. Best decision ever. Sometimes I forget to ditch the pillow because I use it before I sleep. Always regret it in the morning.

    Reply
  44. Life, Love, and other things

    August 7, 2019 5:03 am

    Btw this literally changed my life. I have never slept so well as I do now because of watching this video.

    Reply
  45. dj nonstop

    August 7, 2019 5:45 am

    😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍PRONNNNNNNNNNNNNNNN. IS THE BEST SLEEPING 😴🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯🤯

    Reply

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