Can how you sleep cause you pain?


Can how you sleep cause you pain?

I thought it would be good to touch on a subject that is a bit different to the standard article on training, diet, or supplements, and look at the phase in our day where we spend more time on than these three areas combined – sleep. We have previously explored sleep from the point of view of how much is optimal for people who are engaged in training. Check out our article on sleep and how it impacts your physique first if you haven’t read it. Once you have read it, come back here and you will be in a better position to see why I think you should focus not just on the quantity of sleep but how you sleep.

Can how you sleep cause you pain?

Personal background

In recent months I have been suffering with neck pain which is caused by a herniated disk in my spine which, when it flares up makes movement of the neck uncomfortable. Training makes it worse and so, oddly enough, does sleeping. Surely during sleep nature should allow the body to recuperate from a hard day’s work, so that one’s mind and body is energised for the following day? Why then do I, in common with many others, find that while sleep heals aching muscles, it can sometimes make joint issues worse. From an evolutionary point of view it would not appear to make any sense. Well, as good luck would have it, I recently came across a study (1) which looked at sleeping patterns in detail and it made for fascinating reading.

Evolutionary background

So you are lying in the jungle, stark naked, flat on your back, blissfully unaware of your surroundings...If that was how your ancestors slept then you probably wouldn’t be around today. In fact, if you look at how people outside the West sleep, most particularly the likes of those who live in jungles, or live as nomads without the aid of beds, you will see this way of sleeping is alien.Instead of this, we find that in common with our closest primate ancestors, tribal people sleep in a way designed to ensure they are protected from attack by predators while sleeping. This means being in a position designed to protect vital organs, genitalia, and be alert to any potential predators on the prowl.  

The perils of lying on your back

As most of you probably know, snoring is more likely when sleeping on your back but leaving aside the risk of a sharp elbow in the ribs from anyone who sleeps besides you, what other risks could sleeping on your back pose? From an evolutionary perspective your vital organs are exposed, it will take you longer to stand up in the event of an attack, and your genitals are vulnerable to insect bites (and worse). If we assume that these factors are not so relevant for us western folk now, is it reasonable to assume that while your environment has changed, your body may still be adapted to a more ancient style of sleeping?

Is your back designed to sleep the way we do in the West?

Your spine is made up of three distinct segments, the lumbar, thoracic, and cervical portions, all of which are equally important to optimal back health. When conducting assessments of athletes it is usually easy to see who will have an injury in this area just by seeing the degree of mobility they have in the spine. Unfortunately, lying flat on your back effectively straightens the spine, removing the natural curvature which is required for optimal spinal health. When you sleep it should be a chance for the spine to decompress and lengthen but this will be limited when sleeping on your back.

Stomach sleeping

Sleeping on one’s stomach can be comfortable for many but it will lead to compressive forces on the spine and is an unnatural a way of sleeping as there can be. Exposing the bottom of our body to the ground would mean increasing the exposure of our genitals to insect bites and the like which is one reason you do not see either tribal people or animals asleep in this position. If we never slept this way thousands of years ago, you can be sure your body will not have adapted to it in the space of a few generations.

Lying on our sides

Lying on our sides is the position that most people across the world sleep in and the position that animals from dogs to apes tend to fall asleep in. Tetley observes that when lying on our sides a pillow is not even required as you can either use your arm or else lower your shoulder so your neck is supported. Tetley observes that when the head is deviated towards the ground the mouth will naturally shut which prevents insects from entering the mouths of tribal people and animals who sleep in this posture.With the head down the vertebrae are stretched between what Tetley calls anchors. In effect this means the vertebrae will realign themselves as you sleep aiding mobility when you wake up.


Going back to myself I thought I would try the ideas expressed in Tetley’s study on myself and although it is early days, I have noticed less issues with pain in joints especially my neck. Whether this is down to removing a pillow or focusing on sleeping in an evolutionarily natural way, I do not know for sure, but for anyone else out there who trains hard, eats right, and still finds they struggle with aches and pains it may be worth looking into how you sleep and seeing if changing how you sleep can work to produce a healthier and stronger body.


1. Tetley M (2000): Instinctive sleeping and resting postures: an anthropological and zoological approach to treatment of low back and joint pain