Ask the Doctor: Getting a Good Night's Rest

This question came predominantly from my patients within the past week:

What is the best position to sleep in? What is the best way to  alleviate my lower back and/or neck pain while sleeping?

I hear many variations of this type of question on a pretty regular basis.  Pillows, mattresses and sleeping positions all come into play when it comes to sleeping well through the night. Sleep is such a vital function because that is when our body does the repair work. Without ample sleep, our cognitive functions and immune systems are affected.

If you wake up multiple times throughout the night, your immune system is compromised over time which can lead to quite a few sick days. For growing children and teenagers, sleep is even more important for a constantly changing body. Even into our early 20s, it is recommended we get at least 8.5 to 9 hours of sleep a night.

So what are some things you can do to get a good night's rest?

• Pillows - I tell patients to follow the Goldilocks Principle - meaning it has to be 'just right.' Ideally, the best pillow is one that supports your head and neck while sleeping on your back or on your side. For example, if you sleep on your back, a pillow that is too firm will push your head up and your chin closer to your chest. A softer pillow will allow your head to sink back toward the mattress, extending the cervical spine and not giving it enough support. It is important for the curve in the cervical spine to be supported while sleeping. You should feel like your neck is in a neutral position regardless of whether you sleep on your back or your side. In terms of the type of pillow to purchase, that is a personal preference in my opinion. I have had patients that love memory foam and tempur-pedic pillows with the cervical support built in, and I have some that hate them.  I do recommend trying out pillows in the store before you ever buy them - see what feels 'just right.'
• Mattress - Again, this needs to be 'just right.' The mattress should feel like it is supportive for your neck and low back. A good test is to sit on the edge of a mattress... if the sides feel too weak to support you, that isn't a good mattress. Since we spend about a third of our lives in bed, a good quality mattress is essential. Again, I've had patients that have had a tempur-pedic bed, memory foam, feather beds and pillow tops. You just have to try things out and see what is best for you.
• Stomach Sleeping - This is never a good option. If you sleep on your stomach, your head has to turn to either side so your face isn't buried in a pillow. This puts a lot of torque and tension on the muscles that support the head, neck, and shoulders. Over time, this causes a lot of strain in these muscles, leading to neck and upper back pain and possibly headaches. Stomach sleeping is also not a good position for our lower back, but I've found that this position primarily aggravates the neck in a lot of people. Stomach sleeping is a hard habit to break unfortunately.  Some of my (quirky) recommendations include: surrounding yourself with pillows while sleeping on your back or your side - this may prevent you from rolling onto your stomach in the middle of the night; snuggling right up against your significant other and having pillows on the other side; having lots of cats, my two cats somehow manage to pin me in my sleep. Basically, create a fortress around you and over time your body will get used to back or side sleeping.
• Low Back Pain - If you suffer from lower back pain, a great way to ease it during sleep is to place a small pillow under your knees if you're a back sleeper or between your knees if you're a side sleeper. 

These are just a few tips to sleeping better, and if you do have chronic neck, lower back pain or headaches, it may not just be because you sleep funny or don't have the right pillow or mattress. Please take the time to get this checked out by a health care professional. 

Do you have any questions for Dr. Qureshi? Email them to QureshiDC@gmail.com, or post in the comments section below.