Masters of Sleep

Sleep + Chiropractic Health

Have you ever wondered why you wake up sore in the morning? Or why you have trouble getting comfortable at night? Believe it or not, your mattress or sleeping posture could be to blame.

At Mattress Advisor, we set out to understand why a poor mattress could be the cause of bodily aches and pains and how to fix problems, like poor sleeping posture, that occur when you’re unconscious.

We called on the expertise of Dr. Jon Dominique, DC at Alpine Chiropractic, Dr. Karen Pristavec, DC at Elite Performance Chiropractic and Dr. Nate Vogan, DPT at Stewart Physical Therapy to solve our curiosities about how sleep is related to chiropractic health.

Could Your Sleeping Habits be Causing Body Aches and Pains?

The short answer: Yes. And there are two possible culprits: your mattress and your sleeping posture.

Your mattress

It was quite shocking to hear from Dr. Dominique of Alpine Chiropractic that 20-30% of his patients, who come in with reports of waking up in chronic pain, can relate the issue back to a poor mattress. Dr. Pristavec of Elite Performance Chiropractic agreed, saying roughly 20% of her patients come in with pain that a bad mattress could be contributing to. Both doctors acknowledged most of the time these patients don’t even realize their mattress could be part of the problem.

Why could your mattress be to blame?

A mattresses ability to keep your spine in alignment is very important when it comes to pain management. In fact, keeping a good posture while you’re sleeping is just as important as keeping it during your waking hours.

“A mattress can sometimes ‘hammock’ a person, which creates a pinch point in the lower lumbar spine. This provokes issues of chronic pain,” Dr. Dominique told us.

Graphic of a mattress causing a pinch point in the lower lumbar spine due to 'hammocking'

Most people don’t realize just how important spine alignment is — many chiropractic issues stem from the spine.

“For example, if a patient has pain in the hips, most of the time the problem stems back to an issue with the spine,” Dr. Dominique explained. This hip issue can then lead to a leg issue, and so on.

How do you know if your mattress is really the problem?

Take a look at your sleeping structure. Have you noticed a dip or sag in your mattress? If so, that’s most likely contributing to the problem.

On average, a mattress has a life-span of seven to ten years, so if your mattress has started to sag, it may be time to look for a one. To prevent this from happening, you may consider flipping your mattress.

However, sagging from age isn’t the only way a mattress can throw your spine out of natural alignment. Some mattresses simply have poor support. If you are in the market for a new mattress, you may want to research different brands to see which provides the best alignment. Lucky for you, for every mattress we test, we see how well it keeps your spine in a straight line.

But that’s not all. You should also take inventory of how your body feels at night before you go to bed and when you wake up in the morning. If you wake up more stiff than when you went to bed, then your mattress might be part of the problem.

The most common issues chiropractors see in patients who suffer from sleeping on a poor mattress is low back pain and stiff necks.

Young lady waking up with back pain

“If you are constantly waking up in chronic pain, that’s a pretty good indicator your mattress could be contributing to your problem,” Dr. Pristavec tells us.

Your mattress will never be 100% of the issue, but it can definitely contribute to the problem.

Poor sleeping posture

Your mattress isn’t always the culprit when it comes to waking up with aches and pains. The issue could actually be you — more specifically, your sleeping position.

But how do you fix a problem that occurs when your unconscious? That’s what we asked our Masters.

Ranking the sleeping positions

Sleeping posture is very important when it comes to pain management, in addition to getting a good night’s sleep.

We ranked the sleeping positions, back, stomach and side, from best to worst for your health:

Sleeping positions ranked from best to worst. Man shown sleeping on his back, side and stomach

First Place: The Back

All of our experts agreed — sleeping on your back is the best position, hands down. That’s because your body rests most naturally in this position, which reduces the amount stress on your back and neck.

You should know that even if you sleep on your back, it doesn’t mean your posture is 100% in the clear. For example, sleeping on your back with your pelvis twisted can cause problems. The most important thing to aim for is keeping your pelvis aligned.

Learn more about the best mattresses for back sleepers.

Second Place: The Side

If you can’t sleep on your back, our experts would suggest sleeping on your side next. After all, most people are side-sleepers. The reason sleeping on your side is not as good as sleeping on your back is because it puts pressure on your hips and shoulders.

Additionally, “sleeping on your side can put a rotational force on the lower back, which can cause aggravation in the lower lumbar spine,” Dr. Vogan explained. “We also tend to hunch the shoulders when on our side which can cause tight pecs,” Dr. Pristavec adds.

If you are a side sleeper, “it’s important to make sure your neck is square to your shoulders and not sagging to one side. The implications of this is a muscular issue. It can create impingements of the joints in your neck. These impingements cause pain and tightness in the neck and under the arms,” Dr. Vogan explains.

Image of a man grabbing his neck. The area of pain he feels is illuminated in red

Learn more about the best mattresses for side sleepers.

Last Place: The Stomach

That leaves stomach sleepers. Sorry guys, but the experts confirmed this is the worst position to sleep in by far. Sleeping on your stomach causes you to hyperextend your back and puts pressure on the knees. Hyperextension can strain the ligaments in the back of your spine.  Additionally, this position forces you to crank your neck to one side, Dr. Pristavec informed us. Like Dr. Vogan explained, this causes tightness in the neck.

“It’s rare you’ll find a doctor who recommends sleeping on your stomach,” Dr. Vogan told us. “However, given certain situations, it might be the best for the person,” he continued. (And sometimes, you just can’t help it.)

Learn more about the best mattresses for stomach sleepers.

How can I tell if my sleeping position is the problem?

“If you wake up more stiff than when you went to bed, that’s a pretty good indicator your sleeping posture could be to blame,” Dr. Pristavec shares with us. However, the best indicator is if you wake up in an awkward position.

“Whether it’s your sleeping position or mattress, if you are constantly waking up throughout the night from discomfort, then something is definitely going on,” Dr. Pristavec tells us.

Bottom line, anything that keeps you from restful sleep should be addressed.

If I can’t change sleeping positions, what modifications can I make?

No chiropractor or physical therapist can change their patient’s sleeping position, but they can give them modifications to help them stay in a healthy posture or get comfortable quicker if they experience pain. The main objective of the following modifications is to take pressure off certain parts of the body, like the back, neck, hips and shoulders or to keep you still in one position.

Here are the modifications our experts recommend:

Modifications for Back Sleepers

  • Keep your hips square to prevent a twist in the pelvis
  • If you have low back pain, every once in a while you can put a pillow under your lower legs
  • Put pillows by your hips to keep from rolling over (so you stay in a neutral position)

Modifications for Side Sleepers

  • Put a pillow between the knees to keep the pelvis aligned (aka hips square)
  • If you have mid-back pain, hug a pillow to keep shoulders from caving in

Modifications for Stomach Sleepers

  • If you can, try sleeping in a different position altogether.
  • Put a pillow under your pelvis. This will help keep your back in a more neutral position and take pressure off your spine
  • Stretch in the mornings. A few minutes of stretching will help get your body back in alignment and gently strengthen supporting muscles. Be sure to warm up with a little movement before stretching, and be gentle
  • Use a thin pillow or no pillow at all. The flatter the pillow, the less angled your head and neck will be

Long-Term Implications if the Issue Isn’t Addressed

Sleeping on a mattress of poor quality and having poor sleeping posture will continue to cause joint breakdown and irritation long term. “Prolonged inflammation of the joints speeds up the degenerative process,” Dr. Dominique informs us.

Other long-term effects include muscle tightness, uneven hips and spine misalignment.

Doctor doing neck adjustment in medical office

Advice From The Experts

We asked each of our experts to give us their best tips to improve our sleeping hygiene as it pertains to physical health. Here’s what they said:

Dr. Pristavec

  1. Try to sleep on your back. If you can’t, try to modify your position. You can’t control how you move when you are unconscious, but if you start in a good position, you’ll hopefully stay in that position longer throughout the night.
  2. Get a good pillow that supports your neck.

A portrait of the doctor being featured in this article with a featured quote.Dr. Dominique

  1. Take a good look at what your sleeping on. Make sure you have a good mattress and that you are on the right one for you.
  2. Try to pay closer attention to the position you are sleeping in. Once you know those things, your doctor can help steer you in the right direction.

A portrait of the doctor being featured in this article with a featured quote.Dr. Vogan

  1. Ensure you are getting a good quantity of sleep. If your aches and pains are preventing restful sleep, open that conversation up with your doctor.

A portrait of Dr. Vogan featuring his key quoteNo doctor knows your body better than you. If you are experiencing stiffness or pain throughout the night, have an open conversation with your doctor to get to the root of the problem and find a solution that is best for you.


expert bios

Dr. Jon Dominque, DC, DACO received his Doctorate of Chiropractic from the National University of Health Sciences in 2007. He now owns his own practice, Alpine Chiropractic and Acupuncture in Hickory, NC. Other achievements include a Diplomate in Chiropractic Orthopedics (DACO), which is a specialized field of chiropractic medicine that provides non-operative alternatives to surgical orthopedic healthcare relative to treatment of disorders of the human spine and extremities.

Dr. Karen Pristavec, DC, ART received her Doctorate of Chiropractic from New York Chiropractic College. Post-grad she became full spine certified in Active Release Technique, Webster technique and instrument-assisted soft tissue therapy. She now practices at Elite Performance Chiropractic in Greensboro, NC.

Dr. Nate Vogan, DPT, CMTPT received his Doctorate of Physical Therapy Degree from the University of Tennessee Health Science Center in 2012. Dr. Vogan currently practices at Stewart Physical Therapy in Raleigh, NC. Post-graduation he became a Certified Myofascial Trigger Point Therapist (CMTPT), a practice commonly known as Dry Needling. His special interests include orthopedic injuries, musculoskeletal dysfunction, postural correction, and trigger point therapy.