Why Spine Alignment is Important for Choosing a Mattress

Proper spine alignment while sleeping can help to reduce strain on your muscles and ligaments, relieving pain and allowing you to sleep well.

By Nicole Gleichmann

Apr 8th, 2022

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Ever since we were children, most of us have understood the importance of proper posture. We were told by parents and teachers to sit up straight and not slouch. Our elders were not wrong. Daytime posture is important for our long-term health and wellbeing. However, they were missing a crucial part: how we sleep is just as important for our bodies as how we hold ourselves when we’re awake.

What Is Proper Spine Alignment?

Before you can really know if your spine is in good alignment when sleeping, you should understand what proper posture looks like when standing. The first sign that your body is in proper alignment is when your ears, shoulders, and hips are all in one plane, and this plane is perpendicular to the ground.

Next, there should be some natural curvature throughout your spine, all the way from your lower back to your upper neck. These natural curves help to distribute pressure; without them, compressed vertebrates and chronic pain can result.

Maintaining Healthy Spine Alignment While Sleeping

Just as we should work on our posture during the day, we should work on our body alignment at night. If you sleep in poor alignment, you can experience similar discomfort as you would if you had poor posture during the day. Plus, there are unique problems that can come from poor sleep alignment.

If your spine isn’t well supported and aligned when you sleep, you can experience:

  • Muscle strain
  • Discomfort in pressure points
  • Back, head, and neck pain
  • Frequent waking during the night
  • Tossing and turning
  • Daytime fatigue

What Constitutes Correct Alignment?

Can you imagine the posture and body positioning of proper standing posture as we described earlier? The idea is to keep that alignment when you lie down.

Here are the different parts of the body that you will want to concentrate on:

  • Head: Keep your head in line with your spine; if your head it propped too high or not high enough, leaning to one side or the other, or turned at an odd angle, you have a problem. When your head is not in line with your spine, neither is your neck, resulting in neck pain.
  • Neck: Your neck needs to be in line with your spine while having its natural curve maintained. When your neck is out of alignment, your back tries to compensate, leading to pain throughout your neck and back.
  • Shoulders: Examine where your shoulders are in relation to your back, neck, and head. Your shoulders should be in line with your back, meaning that they should not be on your pillow.
  • Back: Your back should be straight, not rotated. For example, you do not want to be on your back with your legs rotated to one side or the other. A rotated spine can lead to full-body pain.
  • Legs, Hips, and Knees: Your knees ought to maintain a gentle bend, and there should be a bit of space between your knees to keep them in line with your hips.
  • Arms: Your arms should be in line with your body or gently resting in front of it. Do not lie on your arms.

Maintaining Spine Alignment Based on Sleeping Position

Sleeping on Your Back

Back sleeping is usually considered the best sleep position when it comes to proper alignment. If you struggle with back or neck pain, sleeping on your back may help.

To optimize your sleep posture on your back, consider the following:

  • Mattress: Use a mattress that is medium-firm to firm but still allows your booty to moderately sink into the mattress.
  • Head Pillow: Your pillow should support your neck in a neutral position, with your chin neither tilting back nor being pushed towards your chest. Also, never have both your neck and shoulders on this pillow or your spine will be out of alignment.
  • Leg Positioning: Keep your legs in a straight line, without spreading them wide or twisting them in either direction.
  • Knee Pillow: You should use a small pillow underneath your knees to reduce lower-back strain.
  • Lumbar Pillow: Some people will find that a pillow beneath the lumbar region of the spine is beneficial, particularly on a firm mattress.

Sleeping on Your Side

Deciding to sleep on your side can be a good decision for your spine, but you do need to be more cautious. To reduce aches and pains, side sleepers should follow these guidelines:

  • Head Pillow: Your pillow needs to keep your neck in neutral alignment, maintaining the same space between your head and shoulders as when you are standing.
  • Knee Pillow: Use a pillow between your knees to help to prop your knees up to where they are in line with your hips.
  • Leg Placement: You will want to have your knees slightly bent; no bend or an excessive bend are detrimental for spine alignment.
  • Arm Placement: Do not allow your elbows to be above your shoulders, and do not sleep on your arms. It is best to keep your arms at your side or use a pillow to support them out in front of you.

Note: sleeping on your side is the best position for those with sleep apnea to find relief from their symptoms.

Sleeping on Your Stomach

There is no correct way to sleep on your front; no matter how you position your body, your spine will be out of alignment.

Stomach sleepers will usually have their neck turned to one side or the other, and using a pillow can result in an unnatural neck and back curve upwards. Your lower back will often be hyperextended, leading to lower back pain.

Related: Best mattress for back pain

The best thing you can do if you are a stomach sleeper is to try and sleep in another position. It can take time and continuous effort to do so, but eventually, you may be able to sleep even more comfortably on your back or side.

If you do choose to sleep on your front, the best bet is to sleep on a firm mattress and use no pillow or a very thin, firm pillow for your head only.

Related: Best mattresses for stomach sleepers


It is best to sleep on your back or side if you want to get a good night’s rest and wake up without aches and pains. No matter the position you sleep in, do your best to set yourself up to maintain a healthy posture while you sleep.