Good sleep ergonomics, i.e. the anatomical sleeping position and the proper support of the mattress and pillow, keep the body in an optimal position during sleep. Maintaining an ergonomic sleeping position is important for tissues to recover effectively from daytime stress.
- Does the neck get sore during the night? Do you wake up in the morning with a sore back? Are there a stack of different pillows in the closet?
The importance of sleep ergonomics
In 2008, an average of 70 million people suffered from sleep problems, and by 2050, 100 million people are projected to suffer from sleep problems. A person sleeps an average of 8 hours a day, or about a third of their entire life. This is why it is important to pay attention to good sleep ergonomics.
During sleep, the skin is subjected to pressure and twists, when the bony structures press the soft tissues against the bed. This is called pressure stress. If prolonged, the stress exerts a local circulatory disorder, the most typical symptom of which is reddening of the skin. Symptoms may also include sensory changes if the nerve has been compressed. External compression causes an increase in pressure inside the nerve, impairing its blood circulation and ability to function. Conduction of the nerve can be momentarily blocked if a limb is pinched under the body for a long time while sleeping. The disorder lasts from a few hours to a few days and usually heals completely. The main goal in reducing the damage caused by pressure stress is to relieve the pressure on the skin, thus improving blood circulation in the area. The principle is to distribute the pressure evenly over the entire area where the body is in contact with the bed. Pressure stress can be prevented by with the right kind of mattress or by changing the position, which may interfere with night sleep.
The mattress should be such that it adapts to the natural arcs of the body. Since a person does not have any active control on his spine during sleep, the back should be supported in an ergonomic position utilizing the various elastic properties of the mattress. When the spine is supported in a neutral position, it is possible for the body to recover from daytime strains. A non-neutral position of the spine can cause lateral flexion of the spine and unbalanced load on the septum and facet joints. Sleeping on a mattress that is too soft can make it difficult to change position, which in turn interferes with sleep. Too hard a mattress, on the other hand, causes pain due to insufficient support, also interfering with sleep. It would be optimal to choose the mattress individually according to the person’s body structure and needs.
How do I choose the right pillow for me?
The most common cause of neck pain is muscle tension in the neck and shoulders, one of the reasons is awkward postures. Poor cervical and head support at night can potentially cause head and neck pain in the morning. The main function of the pillow is to support the head and neck in a neutral position, so that the structures of the neck-spine are loaded as little as possible during sleep. A cushion that supports the neutral position of the cervical spine may play an important role in the position of the whole body. The pillow should be chosen according to the sleeping position, the width of the shoulders and the stiffness of the mattress so that the neck is supported in an ergonomic position. Properly chosen pillow can reduce pain and improve sleep quality. However, the pillow should be replaced every 2-3 years, depending on how it has retained its properties and shape.
What is the best sleeping position?
How about sleeping on your back?
In general, the most recommended positions are sleeping on your side and sleeping on your back. Properly supported backrest position reduces spine misalignments. A mattress that is too hard or too soft will not support the spine in the right way. With a mattress that is too hard, only the hips and chest are in contact with the mattress and the lumbar and back are poorly supported. The support of a mattress that is too soft is also insufficient to keep the lumbar spine in a neutral position. Inadequate lumbar support during the night may contribute to the development of low back pain, so adequate lumbar support is particularly important.
When sleeping on your back, the pillow should be lower in the middle than on the sides, supporting the neck and keeping your head in the middle position. The pillow should not be held under the shoulders to prevent the shoulders from protruding and the upper part of the chest from flexing (bending). When the thorax is flexed, the neck-spine easily goes into extension and the neck support is deficient. A pillow that is too high will cause the cervical flexion in the supine position, wherein the compression pressure of the anterior portions (fronts) of the spinal spacers. Too low a pillow or sleeping without a pillow may not support the cervical spine at all allowing the cervical spine to be extended.
How about sleeping on your side?
Sleeping on your side is the most typical sleeping position for adults. If the lateral lower limb is moved off the lower one during lateral sleep, the pelvis turns and the spine rotates. From the point of view of the position of the spine, it would be most optimal to keep the lower limbs on top of each other. The right supportive mattress helps keep the spine in an ergonomic position. Putting a pillow between your knees may also help you find the optimal sleeping position.
With a mattress that is too hard, only the pelvis and shoulder area are supported and the spine is laterally flexed like an s-bend. In addition, the shoulder does not sink into the mattress, the support of the spine is inadequate, and the pressure on the shoulder joint causes pain and joint stiffness. If the shoulder is moved out from under the body or the pelvis is rotated, the spine will also rotate. A mattress that is too soft causes the pelvis and shoulders to sink to the bed during Sleeping on your side, causing lateral flexion. When sleeping on your side, the mattress should be sufficiently flexible under your shoulder and hips so that your spine stays in a neutral position.
When sleeping on the side, the pillow should be thicker at the cervical spine than at the head, with the cervical spine being a straight extension of the sternum. A pillow that is too low or too high causes lateral flexion of the cervical spine and possibly also rotation and extension. This causes the facet joints to squeeze to the side of the lateral flexion, which can cause pain. Nerve root openings may also constrict on the lateral flexion side, causing nerve root irritation.
How about sleeping on your stomach?
As a sleeping position, sleeping on your stomach usually feels most comfortable because then the pressure is evenly distributed throughout the body. However, sleeping on your stomach is a bad position for good sleeping ergonomics, because then the whole spine is rotated and in addition the lumbar spine may be overstretched. In the extension of the lumbar spine, the compression pressure of the facet joints and the posterior parts of the septum increases and the compression pressure of the anterior parts of the septum decreases, wherein the change in vertebral spacer pressure directs the nucleus pulposus mass to protrude anteriorly. In addition, the accentuated extension strains the facet joints. As a result of the rotation, some of the filaments in the septum stretch and some loosen, as a result of which the metabolism of the vertebral is disturbed.
In sleeping on your stomach position, the pillow should be placed under the chest, reducing spinal rotations and lumbar hyperexception. While sleeping on your stomach sleeper’s stomach is best supported by a hard or semi-hard mattress and a low pillow that prevent hyperexception of the spine.
When sleeping on your stomach, too high a pillow causes spinal extension and also cervical rotation. Cervical spine extension and rotation cause maximal nerve compression on the rotational side, whereby the diameter of the nerve outlet decreases and the nerve pathway narrows. In the extension of the cervical spine, the diameter of the spinal canal also decreases. As a result of the narrowing of the nerve outlet, the nerve may be compressed, causing symptoms of numbness in the upper limbs.