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erronis

(16,987 posts)
Thu Jun 27, 2024, 12:00 PM Jun 2024

Is there a better head position for sleeping (and clearing out junk)?

This discussion thread was locked as off-topic by eppur_se_muova (a host of the Science group).

https://mccormickmd.substack.com/p/is-there-a-better-head-position-for
Ryan McCormick, M.D.

Sleeping on our sides may be the best position for several reasons, if we can do it comfortably.

Before I present this post I want to add a few disclaimers.

First, there are a lot of unique considerations for individuals, including which sleeping positions are uncomfortable, impair breathing, complicate sleep apnea treatment, etc. A good article I read while preparing this post states: “Sleep habits are highly personal, and the same goes for your ideal sleep position. A side sleeping position has many advantages and fewer drawbacks than a stomach or back position. Ultimately, the position that helps you fall asleep, stay asleep, and get quality rest is the best one for you.”

Second, the science of how our brains wash out the accumulated junk of a full day’s cognitive work while we are sleeping is still very much being studied. There is fascinating stuff to learn, including the magic of the brain’s glymphatic system and washing cycle mode. As a primary care doctor I am not contributing to this research by any means. But I do have a vested interest in helping to prevent or slow neurodegenerative diseases like the ones I see every day (dementia, Parkinson’s, general cognitive decline, etc.)

The typical articles we read about preferred sleep positions concentrate mostly on our physical comfort, breathing, and associated medical issues. So I’m going to quickly summarize that and let the interested reader click through to more information if desired. But then I’m going to spend the bulk of this post examining an overlooked consideration - which sleeping position best clears out the brain of leftover metabolites and junk that can accumulate and lead to long term problems?


In short, side sleeping is generally considered the most beneficial position, offering advantages for spine alignment, reducing snoring and sleep apnea symptoms, and aiding digestion for most people. Everyone is different, and so following your body signals here goes a long way. For example, side sleeping may cause shoulder and hip pain, especially in older people. Forcing it will result in bad sleep. But one of the best tricks I learned along the way in this regard is to put a pillow between my knees while side sleeping. For me, this keeps my spine, hips, and knees in alignment and therefore happier in the morning. Some nuances between side, back, and front sleeping are discussed further in this article from The National Council on Aging (NCOA) as promised. And a bonus article from Houston Methodist on sleep positions.

17 replies = new reply since forum marked as read
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Is there a better head position for sleeping (and clearing out junk)? (Original Post) erronis Jun 2024 OP
I like to rotate like a hotdog. Arne Jun 2024 #1
absolutely fine...for you!!! ret5hd Jun 2024 #7
Ok? How else can you get an even smear of mustard? unweird Jun 2024 #13
I used to do that... 2naSalit Jun 2024 #14
It's difficult to do with the memory foam. Arne Jun 2024 #15
That's no lie! 2naSalit Jun 2024 #16
I'm a side-sleeper EYESORE 9001 Jun 2024 #2
Me too. Left, right, adjust pillow, sleep, repeat. erronis Jun 2024 #6
If you have acid indigestion or GERD, left side only if at all possible... hlthe2b Jun 2024 #3
I am aware of this EYESORE 9001 Jun 2024 #8
Exactly... hlthe2b Jun 2024 #10
Love the long "leg pillow" birdographer Jun 2024 #4
Side sleeper here. I breathe better. Ilsa Jun 2024 #5
On your stomach with wafer thin down pillow. flying_wahini Jun 2024 #9
Old neck won't turn enough and shoulder bursitis. erronis Jun 2024 #11
This is how I ended up snpsmom Jun 2024 #12
That's what I do Yo_Mama_Been_Loggin Jun 2024 #17

Arne

(3,607 posts)
1. I like to rotate like a hotdog.
Thu Jun 27, 2024, 12:04 PM
Jun 2024

Wonder if that's ok?

ret5hd

(21,320 posts)
7. absolutely fine...for you!!!
Thu Jun 27, 2024, 12:27 PM
Jun 2024

but your poor, long suffering partner…

ya’ll go to sleep, sheets/blankets evenly distributed…five minutes later you have it ALL and your bare shivering partner has none!

ask me how i know!

unweird

(2,977 posts)
13. Ok? How else can you get an even smear of mustard?
Thu Jun 27, 2024, 01:38 PM
Jun 2024

I’ll stand by for other suggestions but wiener rotation seems to me to be the optimal way.

2naSalit

(93,098 posts)
14. I used to do that...
Thu Jun 27, 2024, 01:45 PM
Jun 2024

Until I ruined my shoulder, now I sleep on my left side only.

Arne

(3,607 posts)
15. It's difficult to do with the memory foam.
Thu Jun 27, 2024, 01:48 PM
Jun 2024

You may need a giant spatula to flip.

2naSalit

(93,098 posts)
16. That's no lie!
Thu Jun 27, 2024, 01:50 PM
Jun 2024

Glad I don't have to flip much. I use a pillow to keep me from rolling onto my back, the memory foam is great because I don't get flat spots anymore.

EYESORE 9001

(27,562 posts)
2. I'm a side-sleeper
Thu Jun 27, 2024, 12:07 PM
Jun 2024

but I have difficulty getting comfortable. Too many neck-pops for my liking. I need to make some adjustments.

erronis

(16,987 posts)
6. Me too. Left, right, adjust pillow, sleep, repeat.
Thu Jun 27, 2024, 12:12 PM
Jun 2024

It's the sometimes long stretches in the middle of the night when the brain won't shut up....

hlthe2b

(106,571 posts)
3. If you have acid indigestion or GERD, left side only if at all possible...
Thu Jun 27, 2024, 12:08 PM
Jun 2024

Dr. McCormack really should have discussed that--especially given his promotion of right-sided sleeping: "Adopting a right lateral sleeping position, which appears to be most efficient for glymphatic transport and CSF clearance"...

A practicing physician should KNOW that--especially given that 20% or more Americans suffer from full-blown GERD (gastroesophageal reflux disease) ....

EYESORE 9001

(27,562 posts)
8. I am aware of this
Thu Jun 27, 2024, 12:28 PM
Jun 2024

I prefer sleeping on my left side, which keeps the fundus of the stomach at a lower position, leading to lower pressure upon the esophageal sphincter.

hlthe2b

(106,571 posts)
10. Exactly...
Thu Jun 27, 2024, 12:33 PM
Jun 2024

birdographer

(2,527 posts)
4. Love the long "leg pillow"
Thu Jun 27, 2024, 12:10 PM
Jun 2024

I can't sleep without that--lines everything up.

I think head position is vital for side-sleepers. What makes sense to me is to position your head properly above your spine so that you are in a normal position in terms of head, neck, and back. If you open your eyes and gaze ahead, your gaze should be parallel to the headboard or whatever your bed is lined up with (unless it's in a corner!). A string extended from the tip of your nose would be parallel to that headboard. Looking down, letting your chin come off the pillow and hang there, is hard on the neck.

Ilsa

(62,263 posts)
5. Side sleeper here. I breathe better.
Thu Jun 27, 2024, 12:11 PM
Jun 2024

Sometimes I use a pillow for my knees. Sometimes I lean into a king-size pillow.

I wish I could get more uninterrupted sleep, though.

flying_wahini

(8,043 posts)
9. On your stomach with wafer thin down pillow.
Thu Jun 27, 2024, 12:32 PM
Jun 2024

The best way.

erronis

(16,987 posts)
11. Old neck won't turn enough and shoulder bursitis.
Thu Jun 27, 2024, 12:38 PM
Jun 2024

I used to be able to sleep like that but it's been 20+ years.

snpsmom

(791 posts)
12. This is how I ended up
Thu Jun 27, 2024, 12:57 PM
Jun 2024

having surgery for spondylolisthesis. Currently recovering with titanium cages between L4 -S1vertebrae and a number of titanium screws to hold things in alignment. Highly not recommended. As soon as I can tolerate it, I'll be side sleeping.

Yo_Mama_Been_Loggin

(115,966 posts)
17. That's what I do
Thu Jun 27, 2024, 02:03 PM
Jun 2024

I used to use a CPAP until I had a severe throat infection that sent me to the hospital. I've found side sleeping works better for me.

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