The Complete Guide for Side Sleepers

Side sleeping is the most common sleep position, with studies suggesting approximately 60% of adults prefer sleeping on their side. It's generally considered one of the healthiest sleep positions, particularly for reducing snoring and symptoms of sleep apnoea. However, side sleeping comes with its own challenges—from shoulder pain to hip pressure. This comprehensive guide covers everything side sleepers need to know to optimise their sleep quality.

Benefits of Side Sleeping

Before addressing the challenges, let's understand why side sleeping is often recommended by sleep experts:

Reduced Snoring and Sleep Apnoea

When you sleep on your back, gravity can cause the tongue and soft tissues in the throat to collapse backward, partially blocking the airway. Side sleeping keeps these structures in a neutral position, reducing snoring and mild obstructive sleep apnoea symptoms.

Better Digestion

Sleeping on your left side specifically can aid digestion. The stomach and its gastric juices remain lower than the oesophagus in this position, reducing acid reflux symptoms. This position also allows gravity to assist the movement of waste through the colon.

Improved Brain Health

Emerging research suggests side sleeping may help the brain clear waste products more efficiently through the glymphatic system—the brain's cleaning mechanism that operates primarily during sleep.

Pregnancy Safety

For pregnant women, side sleeping (particularly left side) is recommended as it improves circulation to the heart and provides better blood flow to the foetus, uterus, and kidneys.

Common Side Sleeping Challenges

Despite its benefits, side sleeping can cause problems without proper support and positioning:

Shoulder Pain and Pressure

Your shoulder bears significant weight when side sleeping. On a too-firm mattress, this can cause pain and numbness. On a too-soft mattress, your shoulder may sink too deeply, causing misalignment.

Hip Pressure

Similar to shoulders, hips are a pressure point for side sleepers. The hip bone can dig into the mattress, causing discomfort and circulation issues.

Spinal Misalignment

When your spine curves laterally (side to side) during sleep, it can cause back pain and stiffness. This often happens when there's a gap between your waist and the mattress, or when your head pillow is the wrong height.

Arm Numbness

Sleeping on your arm or with your arm in an awkward position can restrict blood flow, causing that unpleasant "pins and needles" sensation.

Facial Wrinkles

While less serious than other concerns, consistent pressure on one side of the face can contribute to asymmetric facial ageing and sleep wrinkles over time.

Optimising Your Side Sleeping Position

Proper positioning is the foundation of comfortable side sleeping:

Head and Neck Alignment

Your head pillow should fill the gap between your ear and the mattress, keeping your neck in line with your spine. Most side sleepers need a medium to high loft pillow. If your pillow is too low, your head tilts down; too high, and your head tilts up—both cause neck strain.

Test your alignment: Have someone take a photo of you from behind while lying on your side. Your spine should form a straight line, not curve up or down at the neck.

Shoulder Positioning

Avoid sleeping directly on your shoulder point. Instead:

• Roll slightly forward so your shoulder sits in front of you
• Keep your lower arm in front of your body, not tucked under you
• Consider hugging a pillow to keep your upper arm supported

Hip and Pelvis Alignment

Your hips should be stacked directly on top of each other. When the top leg falls forward or backward, it rotates your pelvis and stresses your lower back. This is where a body pillow or knee pillow becomes essential.

Leg Position

Slightly bend your knees (not fully drawn up in a tight fetal position, which can restrict breathing). Place a pillow between your knees to:

• Keep hips properly aligned
• Reduce pressure on hip joints
• Prevent your top leg from pulling your spine out of alignment

Body Pillows for Side Sleepers

Body pillows are perhaps the most valuable sleep accessory for dedicated side sleepers. Here's how they help:

Full-Body Support

A full-length body pillow provides simultaneous support for multiple areas: something to hug (keeping your top arm supported), knee separation, and potentially waist support.

Preventing Position Changes

Hugging a body pillow naturally encourages you to stay on your side rather than rolling onto your stomach or back during the night.

Reducing Tossing and Turning

With proper support, your body doesn't need to constantly adjust to find comfort, resulting in more stable, restful sleep.

Choosing the Right Mattress

Your mattress significantly impacts side sleeping comfort. Side sleepers typically need a medium to medium-soft mattress that:

Pressure Relief

• Cushions shoulder and hip pressure points
• Allows these areas to sink slightly into the mattress
• Memory foam and hybrid mattresses often excel at this

Support

• Supports the waist to prevent spinal curvature
• Maintains alignment despite allowing sink at pressure points
• Zoned mattresses with different firmness areas can be particularly effective

Responsiveness

• Allows easy position changes without feeling "stuck"
• Important if you switch sides during the night

If you're waking with shoulder or hip pain, your mattress might be too firm. If you're waking with back pain, it might be too soft or lacking adequate support.

Addressing Common Side Sleeper Problems

Waking with Shoulder Pain

Solutions to try:

• Use a mattress topper for additional cushioning
• Roll slightly forward rather than sleeping directly on your shoulder
• Hug a pillow to take weight off the lower shoulder
• Alternate which side you start on each night
• Consider a mattress with better pressure relief

Waking with Hip Pain

Solutions to try:

• Place a pillow between your knees to reduce hip strain
• Add a mattress topper for hip cushioning
• Keep knees slightly bent, not pulled up tightly
• Stretch hip flexors before bed
• Consider if your mattress is too firm

Waking with Back Pain

Solutions to try:

• Use a pillow between knees to align hips
• Check that your head pillow isn't causing neck misalignment
• Consider a small pillow or rolled towel at your waist for support
• Try a C-shaped body pillow that supports your back
• Your mattress might lack adequate support

Arm Numbness or "Dead Arm"

Solutions to try:

• Never sleep with your arm under your head or pillow
• Keep your bottom arm in front of your body, slightly away from it
• Hug a body pillow to position your top arm comfortably
• If you wake with numbness, gently move the arm to restore circulation

Products That Help Side Sleepers

Beyond body pillows, several products can improve side sleeping comfort:

Knee Pillows

Smaller than body pillows, these contoured pillows fit between the knees specifically. Good for those who find full body pillows too bulky.

Side Sleeper Pillows

Head pillows designed specifically for side sleepers, often with extra height and contouring to support the neck gap.

Mattress Toppers

Memory foam or latex toppers add pressure relief to a too-firm mattress without replacing the entire mattress.

Adjustable Pillows

Pillows with removable fill allow you to customise the loft to your exact needs.

Side Sleeping Tips for Better Rest

• Alternate sides: Starting on different sides each night distributes pressure more evenly over time
• Pre-sleep stretching: Gentle shoulder and hip stretches can reduce tension and improve comfort
• Check your setup regularly: Pillows compress over time; reassess your support periodically
• Be patient with changes: Your body needs time to adjust to new pillows or positions
• Listen to your body: Pain is a signal something needs adjustment

Side sleeping, when done correctly, offers significant health benefits and comfortable rest. The key is proper support and alignment. With the right pillows, mattress, and positioning techniques, you can enjoy the advantages of side sleeping while avoiding common pitfalls like shoulder pain and spinal misalignment.