A good night's sleep is something we all desperately want and need equally, but so millions of people around the world just simply aren't able to get adequate zzz's. This episode covers a little bit of sleep anatomy, the different sleep stages, why we sleep, and finally some details on the different sleeping positions and how to make them more comfortable.

Sleep is something we know we all need, but is really poorly understood. We know how sleep happens, but we are pretty much totally in the dark when it comes to why, and there really isn't even one common theory that scientists think is happening. There are several.

• Inactivity theory - simply put, the theory states that if we are quiet and still during hours of vulnerability (aka: darkness) then we are more likely to survive the night.
• Energy conservation theory - we need to conserve the energy we have (and regain some) and therefore sleep is necessary to do this.
• Restorative theory - sleep has been shown to boost the immune system, help muscles grow and tissues heal, secrete human growth hormone, etc. Sleep has been shown to not only be restorative, but also necessary. When we deprive a rat of their sleep, it will die within a few weeks. A similar phenomenon is thought to occur in humans.
• Brain plasticity - this theory states that sleep is required for the structural organization and neural connections of the brain. This is supported by the fact that we need less and less sleep as we get older. As we do get older, this brain plasticity theory morphs into how we learn & retain memories.

Memory retention is a big reason (we think) for sleep. There are three functions of memory: acquisition, consolidation & recall.

• Acquisition is the physical act of absorbing new information. This can only be done while you are awake.
• Consolidation is the process of taking the information we have acquired throughout the day and forming them into memories. This is the portion that can only be done during sleep.
• Recall is the ability to actually access the memories you have made, whether you want to or not.

This episode also talks about sleep positions. I talk about this all the time in my office, partially because I ask every patient, and partially because people are so curious as to how they should be sleeping. There is a lot of information on sleeping positions out there, so let's get to the bottom of it.

Back sleeping

Sleeping on your back gets a bad rap. It actually has a ton of positives to it and, if you do it right, is pretty healthy for your spine.

Sleeping on your back allows for a pretty even weight distribution across the entire body. This is good because if any one body part is sore, having the weight spread elsewhere will help decrease the amount of pain you are feeling at night. Sleeping on your back also allows us to keep our neck in a relatively neutral position meaning that we aren't going to be in any funny positions during the night.

But - back sleeping does not come without its problems. It is not super supportive for the low back because laying completely flat actually flattens out the natural & healthy curves of your lumbar spine. My fix: put a pillow underneath your knees. This is going to give the natural curve back to your lumbar spine and make sleeping a whole lot more comfortable and a whole lot healthier for your spine.

 

Stomach sleeping

This is the worst position to sleep in and, for the sake of transparency, this is also the position I sleep in. I know, I know. Do as I say, not as I do!

There are two main reasons sleeping on your stomach is bad for you:

• Your neck - sleeping on your stomach forces you to turn your head to one side so that you don't suffocate yourself. This puts a lot of strain on the joints and muscles of the upper back and neck which leads to pain.
• Your shoulder - sleeping on your stomach also forces you to throw one shoulder above the head. Now not everyone does this, so maybe force was a bit of a strong word, but most people do. This is going to put extra strain on the muscles of the shoulder & rotator cuff. If you work out or play any sort of shoulder-intensive sports, this is likely going to be painful for you at some point.

Now that I have told you all that I sleep like a monster, let's talk about how to transition from sleeping on your stomach to sleeping on your side or back, which is a process I am currently doing. And let me tell you… it is hard.

One way that I have found to be particularly helpful when sleeping is to lay on my side with my bottom leg straight and my other leg bent on top of a pillow. I have found that this has given me the deep touch pressure that I find I need to fall asleep (which is why I fall asleep on my stomach in the first place). You might be wondering what deep touch pressure is… don't worry, there is a podcast episode coming on that; stay tuned!

Another way that is common is to sleep on your back (with that pillow under your legs) while also hugging a pillow. Again, this is for that deep touch pressure that helps so many people relax. Alternatively to a pillow, you can also use a weighted blanket. Now I am a big fan of my weighted blanket, and although I don't use it to sleep, I think it might be time to try!

Side sleeping

A lot of patients tell me that this is the position that they have heard is the best. My opinion - a tie between side sleeping & back sleeping, and here is why. Side sleeping can be painful. It distributes your weight across the least amount of body mass therefore providing a lot of pressure to the points that do touch the mattress. The other reason: too many people sleep with their arm above their head. I know that this seems like the most natural position for that arm, and it likely is, but there is a better way.

Hug a pillow. When you hug that pillow when you sleep it forces you to bring that arm down relieving some of the tension in your shoulder & arm. If you have ever injured your rotator cuff and struggled to sleep, this tip could be a game changer for you. But, my tips are not over… you'll need a second pillow for this one. 

The most important part of sleeping on your side is putting a pillow in between your legs. This stops your low back from rotating and keeps your spine in the right alignment. Plus, it is more comfortable not to have your knees knocking together in the middle of the night. 

Before I wrap things up, I want to tell you about a really great resource that I have made for you all. It is a guide called 5 Tips for Getting a Good Night's Sleep. It is full of really great, research-backed & actionable things you can do to get a good night's sleep. Head to www.drdonaldlittlewood.com/sleep to get yours… you won't regret it. Trust me on this!