To sleep… perchance to rest those weary bones…

news: To sleep… perchance to rest those weary bones…

A GOOD night’s sleep is something we all appreciate as we know only too well the effects of a bad one – feeling irritable, unable to concentrate, physical exhaustion and maybe even aches and pains in joints.

Over half of all adults sleep seven hours a night, and it is important to ensure that those hours are spent with the body correctly supported and aligned.

Sleep posture

There are four main sleeping postures you can adopt:

• Lying on the right or left side

• On your front

• On your back

• In the foetus position

Lying on your side can take a variety of forms. Some people lie with their knees slightly bent and rest both arms by their side, or stretch them out in front. Others may adopt the foetus position, where their knees are bent high at a right angle to the body.

Care should be taken when lying on the side, especially if the mattress is soft or if the sleeper has an hourglass figure. Sinking into the bed may cause an asymmetrical strain to the lower back. In extreme cases, unnecessary pressure to the hip could lead to bursitis – inflammation of the sack of fluid on the side of the hip – particularly if the sleeper is overweight.

Lying on the back can take two main forms: your arms pinned to your sides or up around the pillow (sometimes leading to shoulder problems). If the legs are kept straight, causing the back to arch, this may lead to unnecessary strain on the structures of the lower back.

Some people lie on their front with arms by their sides or wrapped around the pillow. Others place their hands around the pillow and turn their head to one side. Physiotherapists tend to avoid encouraging this posture, because the sleeper is more likely to move out of the midline position and sustain an asymmetrical strain to the neck.


Physiotherapists are often asked to provide advice on pillows – in general the type and number of pillows used will depend on how wide your shoulders are to the neck, the sleeping position and personal preferences. You may prefer to use an orthopaedic pillow, which is a pre-shaped pillow formed to fully support the neck and head. Alternatively, you can make your own by rolling a hand towel widthways and sliding it into the pillowcase along one long edge, thus providing extra support to the neck, regardless of which way you turn. When determining the number of pillows to use, consider that having too many may mean they tilt your neck forward, or too few pillows may tilt your head back. Similarly, if lying on your side, be sure the gap between your head and shoulders is filled by pillow(s), so that your neck remains correctly aligned. Find a balance that enables you to maintain the midline position. If you suffer from allergies triggered by dust, find an appropriate alternative.

Choosing the right mattress

It is important to find the mattress that suits your needs. Physiotherapists recommend a mixture of support and comfort, and suggest opting for a mattress that is on the firm side of medium. Try out a few before buying – lying on each for at least 20 minutes at a time. If you suffer from allergies triggered by dust, find a suitable mattress, but be sure it is supportive in keeping you in the midline position. If sleeping with a partner, consider differences in body weight, as different levels of support may be required. Purchasing two single mattresses for a double bed may help here.


If it is a hot night, wear comfortable bedclothes that will keep you cool. Keep yourself covered using a summer duvet or sheet. Keep a window open slightly (better if you have screens at the window to prevent a night tortured by mosquitoes). If you do not have air conditioning, try placing a bowl of ice on the bedside table with a fan running behind it. This will help cold air circulate the room.


Exercising on a regular basis can help to improve sleep patterns, but try to avoid exercising late in the evening, as the endorphins released by the brain during exercise can prevent you from falling asleep. Gentle exercise for 20 minutes three times a week can help the body use up excess energy, helping you to sleep more easily at night. Exercise can stabilise blood sugar levels. Low blood sugar levels can decrease energy and effect concentration.

Look after your back

Ninety-five per cent of people suffer from back pain at some point in their lives, and poor posture is often to blame. Looking after your back is vital to a good night’s sleep.

This article is a general source of information and individual needs and requirements may vary. If you have difficulty in finding comfortable sleeping positions, or find that you wake with pain and/or sore joints, consider consulting a physiotherapist. As well as advice on posture and positioning, they can offer relaxation and breathing techniques, appropriate exercise and advice on back and joint care.

Here’s hoping that you all…sleep well!

By Susan Gardiner

M.C.S.P. S.R.P.